South Dakota already has the longest abortion waiting period in the country, forcing women to wait 72 hours before being able to access the legal medical procedure. But the Republicans in the state want to lengthen it even further — both chambers of the legislature have approved a measure to exclude weekends and holidays from that three-day waiting period, and the legislation now awaits Republican Gov. Dennis Daugaard’s signature.

No other state with this particular abortion restriction defines its waiting period by limiting it to business hours. Proponents of the measure claim that the state needs to extend the 72-hour wait to give women seeking abortions enough time to seek counseling at a “crisis pregnancy center” (CPC). In fact, CPCs are anti-choice organizations that have a long history of attempting to dissuade women from making their own reproductive choices, often by disseminating misleading medical information about abortions.

Although this type of emotional manipulation is a popular tactic among abortion opponents, forced counseling and waiting periods don’t actually change women’s minds about whether or not to terminate a pregnancy. Mandatory waiting periods are simply a method of limiting women’s reproductive rights by forcing them to overcome additional hurdles to having a voluntary medical procedure.

That’s why South Dakota’s stringent 72-hour waiting period has been tied up in court for the past year — but, since the local women’s health groups are being forced to focus their resources on combating other pressing attacks on reproductive rights, the legal challenge has been dropped and the law may soon take effect. And if Daugaard adds his signature to the bill to exclude weekends and holidays, the law that takes effect will be even more restrictive than the original one.

With Congress engaged in a contentious fight over how to overhaul the nation’s broken immigration system, lawmakers from both parties — including President Obama — see eye-to-eye on at least one aspect of the debate: previously undocumented immigrants who achieve provisional legal or deferred action status should not be eligible for government health care benefits or insurance subsidies.

But according to the Kaiser Family Foundation’s (KFF) February tracking poll, Washington is out of touch with a strong majority of Americans, who believe that such immigrants should be able to access care with the help of government resources:

The survey finds that even Republicans are relatively split on providing Medicaid benefits to low-income immigrants with provisional legal status. KFF’s report goes on to underscore the largely-ignored reality that even lawfully present immigrants — including those who were never undocumented, and particularly those with low incomes — have to jump through hoops in order to gain coverage. KFF conducted a more thorough analysis on this exact issue earlier this month in order to highlight the discrepancies between naturalized citizens’ and low-income immigrants’ access to services:

The long waiting periods that low-income immigrants must endure in order to get Medicaid coverage are particularly troubling given the fact that poorer immigrants likely cannot afford private insurance on the individual market and usually work for employers that do not provide their workers with health coverage. That perfect storm of coverage gaps perpetuates a system in which poor immigrants are forced to pursue care at underground, cash-only local clinics with little public oversight, such as Los Angeles’ ubiquitous neighborhood “bodega clinicas.”

Eliminating these barriers to health coverage by eliminating the Medicaid waiting period for low-income legal immigrants and allowing DREAMers and other immigrants who achieve provisional legal status — assuming comprehensive immigration reform passes, that is — to access Medicaid and Obamacare’s insurance subsidies would actually strengthen America’s health care system, as more people would be able to afford their care and receive cost-saving preventative services. Such reform policies are clearly supported by the factual evidence — and also, as it turns out, by the American people.

The news broke today that the soft-core porn company Girls Gone Wild will file for bankruptcy. The company’s decision was largely related to a debt owed to the casino Wynn Las Vegas thanks to the actions of founder Joseph Francis.

But that’s not the only legal trouble that Francis and the company have found themselves in recently. GGW has faced a whole slew of lawsuits for exploiting women, which have substantially contributed to Francis’s financial troubles.

In their bankruptcy filings, GGW cites another debt owed to Tamara Favazza, a woman who sued the company for putting her on film against her will. She won the suit, along with $5.8 million from Francis:

Favazza sued Francis in 2008, claiming someone exposed her breasts while filming in a bar in St. Louis for the “Girls Gone Wild Sorority Orgy” DVD series, according to court documents.

Favazza, a St. Louis resident, won a $5.8 million judgment and then sued Francis, GGW Brands and Mantra Films last year in federal court in Missouri to collect.

GGW Brands called Favazza’s claim a “trade debt” in its Chapter 11 petition. In bankruptcy, trade debts are owed to suppliers, vendors and other service providers.

Favazza is far from alone in demanding remuneration from GGW.

Take, for example, Lindsey Boyd. Now 26, Boyd originally sued the company in 2004 for running video of her as a 14-year-old flashing a cameraman for beads. The case was ultimately decided in November of 2012 — and Boyd lost not because her claim was inaccurate, but because her home state of Georgia had no law in place that protected her photo from being used for commercial use against her consent. In the year 2008, a total of four women sued Francis collectively with similar claims of emotional damages from being filmed underage. Because the company had waivers for them, their cases were also tossed.

Francis has openly admitted to the exploitation that seemed integral to his company’s business model. In 2006, he plead guilty to exploiting minors and paid a fine of $500,000 after admitting that he didn’t keep track of the identities and ages of the women (or girls) captured in his videos. He similarly plead “no contest,” and served a year in jail, for charges of child abuse and prostitution. He was required to post a $1.5 million bond, which likely added to his financial woes.

Ultimately, GGW may blame Wynn, a man, for bringing its empire to the ground. But it’s Favazza’s role in GGW’s bankruptcy that is the most important symbolic victory. Her case speaks for countless women who will be glad to see the company go down, even if the unhinged man at its helm insists it can continue to operate.

Although teen birth rates are dropping, the United States still has the highest rate of teen pregnancy in the developed world. Particularly since American teens are often shamed about their sexual choices, rather than receiving the actual resources they need, the country has a long way to go when it comes to the way it approaches teen sexuality. The results from a new study underline the point that although abstinence education programs don’t work, a different focus on youth services can effectively lower the rate of teen pregnancies.

Researchers from University of Minnesota found that teenage girls at high risk for unintended pregnancy were more likely to take steps to lower their risk of becoming pregnant, like regularly using condoms and birth control pills, after receiving additional support from a youth-focused program. Over the course of their study, over 250 sexually active girls between the ages of 13 and 17 were split into two groups — about half were placed in a “Prime Time program” designed to help mitigate risky sexual behaviors by providing personal case management and youth leadership opportunities, while the rest of the teens didn’t receive any special counseling or support. Significant differences emerged in the teens’ sexual behavior:

All of the participants completed a survey two years after enrolling in the study. This was six months after the girls in the Prime Time intervention completed the program.

The girls in the Prime Time program reported “significantly more consistent” use of condoms, birth control pills or a combination of both types of contraception than those in the control group, the researchers found.

The girls in the Prime Time program also reported increases in family connectedness and self-confidence to refuse unwanted sex, as well as reductions in the perceived importance of having sex, the study authors noted in a journal news release.

Ultimately, as the study’s authors concluded, “health services grounded in a youth development framework can lead to long-term reductions in sexual risk among vulnerable youth.” But those health services may not be widely available across the country — particularly in rural areas that tend to have conservative attitudes about sex, where teens may not feel comfortable seeking out the resources they need.

In particular, the 26 states that require health classes to push ineffective abstinence-only curricula — a misguided approach to sexual education that teaches adolescents to be ashamed of their bodies, rather than equipping young people with the tools they need to safeguard their health — would actually be better served by investing money in support programs for at-risk youth. If the U.S. reoriented its approach to teen sexuality, including acknowledging the fact that young men also have a role to play in preventing unintended pregnancies, the country could continue taking steps toward improving its relatively poor sexual health.

On Wednesday, First Lady Michelle Obama launched her third “Let’s Move!” tour to combat childhood obesity. Before she kicked off the tour in Mississippi, Illinois, and Missouri, Mrs. Obama appeared on “Good Morning America” to praise her campaign’s success in changing children’s eating and exercise habits. She also unveiled Let’s Move latest initiative, the MyPlate Recipe Partnership geared toward parents looking for easy, nutritious recipes:

OBAMA: We’ve really changed the conversation in this country. When we started, there were a lot of people in this country who would have never thought that childhood obesity was a health crisis. But now we’re starting to see some movement on this issue. Our kids are eating better at school. They’re moving more. And we’re starting…to see rates of obesity coming down like never before.

Childhood obesity rates are indeed showing small declines for the first time in decades, especially in cities with aggressive nutrition policies. As Mrs. Obama pointed out, “Let’s Move” has helped call attention to the childhood obesity crisis, and one of her cornerstone achievements was comprehensive school lunch reform that increased funding for public school meals and gave the USDA the ability to regulate foods sold in schools.

Besides school lunch reform, however, “Let’s Move” has deliberately veered away from pushing actual legislation, instead focusing on personal responsibility in nutrition and fitness. That’s a very different approach than the one Mrs. Obama took during the inception of her fight against childhood obesity. In 2010, the First Lady gave a fiery speech at a Grocery Manufacturers Association conference, arguing that changing personal habits won’t work if big companies like Kraft and General Mills continue to target children with misleading ads for sugary, fatty food:

This is a shared responsibility. That’s why I’ve gone to parents and I’ve asked them to do their part. They have a responsibility to watch what their kids eat and teach good habits.[...]And all of you have a responsibility as well.

And we need you not just to tweak around the edges, but to entirely rethink the products that you’re offering, the information that you provide about these products, and how you market those products to our children. That starts with revamping or ramping up your efforts to reformulate your products, particularly those aimed at kids, so that they have less fat, salt, and sugar, and more of the nutrients that our kids need.

As a mom, I know it is my responsibility — and no one else’s — to raise my kids. But what does it mean when so many parents are finding that their best efforts are undermined by an avalanche of advertisements aimed at their kids? And what are these ads teaching kids about food and nutrition? That it’s good to have salty, sugary food and snacks every day — breakfast, lunch, and dinner?

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Now that the Republican governors in Ohio and New Jersey have both announced their support for expanding their states’ Medicaid programs under Obamacare — joining Democratic-led New York and Maryland — Pennsylvania is surrounded. Gov. Tom Corbett (R) has resisted cooperating with this Obamacare provision so far. But now, members of his own party are beginning to pressure him to change his mind and join his neighbors:

Now the heat is coming from some of Corbett’s fellow Republicans in the state legislature.

State Rep. Gene DiGirolamo (R., Bucks) said Wednesday that he supported Medicaid expansion because it would provide health insurance for an estimated 700,000 Pennsylvanians, many in low-wage jobs.

“We should do everything possible to get this done for the state of Pennsylvania,” DiGirolamo, chairman of the Human Services Committee, said Wednesday. “Most of the people we are talking about are in the workforce making $10 to $12 an hour and have no health care.”

At the same time, a top Senate Republican said he had tasked his staff with examining Medicaid expansion costs and benefits in advance of budget negotiations in the spring. Appropriations Committee Chairman Jake Corman (R., Centre) said that the Senate GOP caucus might take a position of its own on Medicaid expansion — he did not elaborate — and that the issue could figure into the budget process.

Partisan resistance to Obamacare is finally beginning to wane, as eight Republican leaders have now conceded that resisting health reform on a state level might not be worth the political statement. The GOP leaders who have agreed to carry out this provision of the health reform law have all acknowledged that it will make financial sense for their state budgets — since the federal government will finance the full cost of expansion for the first several years — as well as help ensure that thousands of low-income Americans receive the care they need.

And the pressure may be getting to Corbett. On Thursday, the day after Christie announced he supports Medicaid expansion in New Jersey, the Pennsylvania governor agreed to meet with HHS Secretary Kathleen Sebelius to “discuss questions” about his options for expanding the Keystone State’s Medicaid program under Obamacare.

Arkansas’ GOP-controlled legislature has voted to override their governor’s veto of a “fetal pain” abortion ban, ensuring the legislation will immediately take effect. Gov. Mike Beebe (D) vetoed the measure on Tuesday, explaining he felt the 20-week ban would run afoul of women’s constitutional right to an abortion under Roe v. Wade, but Arkansas lawmakers can override the governor with a simple majority in both chambers.

Arkansas will join the seven other states that currently have “fetal pain” laws on the books, which are based on the junk science that fetuses can feel pain at 20 weeks of pregnancy. Under Roe v. Wade, abortion rights are protected until the point of viability, which typically occurs around 24 weeks — so fetal pain bans are an effective way to chip away at women’s reproductive rights. Two of those measures are currently being blocked from taking effect, the same constitutional challenge that Beebe suspects may await Arkansas.

“We made the best case we could in our veto letter and explained the legal problems with the law and what that could cost our people,” a spokesman for the governor told Reuters. “The final say, however, remains with the legislature.”

The American Civil Liberties Union of Arkansas has already pledged to challenge the new law. But the anti-choice GOP lawmakers in the state are unconcerned about potential legal challenges. The House voted 53-28 on Wednesday afternoon to override Beebe’s veto, and the Senate voted 19-14 on Thursday morning.

Unfortunately for the women in Arkansas, their Republican lawmakers may not stop there. The state is also considering an even more stringent “heartbeat” ban to outlaw the abortion procedure after just 12 weeks, at the point when a fetal heartbeat can be detected with an abdominal ultrasound. That would represent one of the harshest abortion bans in the entire nation, and the legislature could once again push it past Beebe even if he vetoes it.

Gov. Nikki Haley’s (R-SC) state has a serious weight problem — and she knows it. That’s why last week, flanked by public health officials, Haley announced that she will push for a controversial overhaul of South Carolina’s nutritional assistance program that would limit food stamp purchases to “healthy” items. It’s a well-meaning idea meant to tackle the state’s rampant obesity epidemic and its resulting health care costs — unfortunately, the proposal isn’t the most effective way to tackle obesity, and implementing it could end up preventing low-income Americans from receiving adequate nutrition.

Any changes to a state’s food stamp program require a waiver from the federal government, and no state has successfully received one to date. The Charlotte Observer reports that Haley will hold group meetings with food stamp recipients, public health advocates, food makers, and various other officials to determine which foods should be purchasable with food stamps — and which shouldn’t — before requesting the waiver, in an effort to sway the federal government by putting up a unified front. That means that the specifics of Haley’s plan have yet to be fleshed out, and her office did not respond to ThinkProgress’ request for more details.

Still, Haley’s statements on the matter suggest that she wants to discourage South Carolina residents from using food stamps to purchase high-fat, high-calorie, and high-sodium products. “That $1 billion [in federal nutritional assistance] no longer will go to candy and chocolate and sodas and chips — it’ll be going to apples and oranges and things that are healthy,” she said.

That’s certainly an admirable goal considering South Carolina’s abysmal public health statistics: a full third of the state’s 4.7 million resident are obese, making it the eighth most obese state in America; another third are overweight; and the state ranks second in the country for obesity-related diabetes risk. Furthermore, the cost of treating obesity-related illnesses for low-income Americans accounts for almost 12 percent of national Medicaid spending — and likely an even higher percentage in South Carolina, where 18 percent of residents are on the federal Supplemental Nutrition Assistance Program (SNAP).

But the efficacy — and the practical logistics — of Haley’s approach remains an open question. Proposals to limit food stamp purchases are a source of fierce debate among both public health and poverty advocates — not to mention supermarkets and food makers who argue that the transaction costs of separating SNAP from non-SNAP products would be too high or hurt product sales.

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The Kansas Senate Judiciary Committee recommended a bill yesterday that would effectively allow doctors to lie or withhold information about debilitating genetic conditions or birth defects in order to influence women’s decisions about their pregnancies.

Kansas SB 142 provides blanket protection from “wrongful birth” lawsuits to doctors, with section 1(a) reading:

“No civil action may be commenced in any court for a claim of wrongful life or wrongful birth, and no damages may be recovered in any civil action for any physical condition of a minor that existed at the time of such minor’s birth if the damages sought arise out of a claim that a person’s action or omission contributed to such minor’s mother not obtaining an abortion.”

The Arizona State Senate passed a similar law in 2012, but that proposal contained a provision absent from the Kansas bill allowing wrongful birth suits in the event of “an intentional or grossly negligent act or omission.”

The proposal was included as a provision in an omnibus anti-abortion bill last year, but was so controversial that it ending up being submitted as a standalone bill in this cycle, according to Kansas NOW lobbyist Elise Higgins. Despite Kansas’s dismal reproductive rights record, Kansas legislators have already introduced over 90 pages of anti-choice legislation in 2013.

In a letter sent to the White House on Tuesday, 22 Republican senators are demanding that President Obama propose Medicare cuts before the chamber considers Treasury Secretary nominee Jack Lew.

The letter is part of an ongoing GOP smear campaign against Lew alleging that, during his tenure as director of the Office of Management and Budget (OMB), Lew and the Obama Administration failed to comply with a law requiring the White House to submit Medicare cost-cutting proposals “whenever the program’s trustees express concerns about its solvency in their annual report.” The senators suggest that Lew should have known about that legal requirement and spurred the Administration to take action by formally proposing Medicare cuts:

“We find it stunning and noteworthy that so far Mr. Lew has not provided adequate responses to congressional inquiries on the matter,” the senators wrote to Obama Tuesday.

“Congress needs a clearer understanding about his role in the violation of this law, including exactly when Mr. Lew first became aware of this legal requirement and what counsel, if any, he provided the administration on whether it should comply with this law.”

But there are some glaring falsehoods in the senators’ claims and their subsequent demand for an Administration plan to curb Medicare cost growth.

First, calling for Medicare cuts to ensure the program’s long-term solvency is based on the assumption that inflation in medical services — and, consequently, spending on health care entitlements like Medicare — will continue to balloon at staggering rates indefinitely. But the key to reducing national health expenditures is to reduce the actual price of consuming care — so if forces in the health care market facilitate cost reductions in medical technology and services, then entitlement spending will drop accordingly. Recent evidence shows that that is exactly what is happening, as the recent slowdown in health care cost growth has reduced Medicare’s future projected spending by over half a trillion dollars, all without a single policy change. Furthermore, a just-released GAO report found that if Obamacare and its cost-containment mechanisms are fully implemented, then future spending on Medicare would decrease “from 6.2 percent of GDP in 2035 in the simulations run before [Obamacare] was enacted to 4.7 percent in the simulations run immediately after enactment.”

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Ohio Gov. John Kasich is one of eight Republican governors who have so far said their state will participate in Obamacare’s Medicaid expansion. But as the Huffington Post points out, Kasich stands apart in one respect: Of those Republican governors, he is so far the only one to explicitly tie his decision to the values of his religious faith.

While he remains opposed to Obamacare as a whole, the Ohio governor indicated his support for the Medicaid expansion in his annual State of the State remarks last week, pointing to the public health insurance program’s potential to help care for the most vulnerable residents in his state:

The Bible runs [Kasich's] life “not just on Sunday, but just about every day,” he said in his annual State of the State address Tuesday.

“And I’ve got to tell you, I can’t look at the disabled, I can’t look at the poor, I can’t look at the mentally ill, I can’t look at the addicted and think we ought to ignore them,” he told the audience of about 1,700 lawmakers, state officials and other guests. […]

“Put it in your family,” Kasich said. “Put somebody that is in your family who becomes the wayward child. And they come home one day, they can’t get a job. Put it on your doorstep, and you’ll understand how hard it is.”

Kasich was raised Catholic and worships regularly in an Anglican church. For more than 20 years, he has met every other Monday with a small group of men to study the Bible. And he has written a book about how the experience has helped him in his search for answers.

That’s a theme in keeping with a broader push that’s been made in the expansion’s favor. Earlier this year, religious and community leaders in Ohio held a rally at Olivet Institutional Baptist Church in Cleveland, calling on their state to participate in the Medicaid expansion. And back in September, over 100 national, state, and local faith leaders released a statement employing Republican governors as a whole to accept the expansion. Sister Simone Campbell, the executive director of the Catholic social justice group NETWORK, said in conjunction with the release that, “My strong support of Medicaid expansion comes out of my pro-life stance because it is the right and moral thing to do.”

Florida Gov. Rick Scott (R) wasn’t as explicitly religious as Kasich when he announced his own support for Medicaid expansion, but he did come close. As the Huffington Post noted, Scott said his mother, who passed away last year, taught him that “America’s greatness is largely because of how we value the weakest among us.”

Because the federal government will fund the first several years of the Medicaid expansion, reports have estimated that Ohio will actually enjoy $1.43 billion in net fiscal savings to its state budget over the next eight years if it participates. And failing to expand Medicaid would actually cost the state about $8 billion in additional health care costs, largely because a higher uninsured population would mean greater spending on uncompensated care.

The Indiana senate advanced a measure on Tuesday to require all women to undergo an unnecessary, and potentially invasive, ultrasound procedure before taking the RU-486 abortion pill.

The original version of the bill actually mandated two tranvaginal ultrasounds — before and after women took the pill. Yesterday, before the Senate vote, GOP lawmakers agreed to remove the second ultrasound requirement to ensure the legislation’s passage. Their efforts were successful. Despite bipartisan opposition as four Republican state senators broke from the rest of their party to oppose SB 371, the measure will now advance to the GOP-controlled House:

The bill passed on a 33-16 vote despite a chorus of complaints from opponents who said it’s a step too far into doctors’’offices without improving their patients’ health.

“This bill is not about patient safety. It’s about patient harassment,” said Sen. Vaneta Becker of Evansville, who was one of only four of the Senate’s 37 Republicans to join the 12 Democrats who opposed the bill.

Now, Senate Bill 371 heads to the House, where Republican Speaker Brian Bosma of Indianapolis said he expects it to win passage as well — perhaps after some changes.

And this legislation has another anti-choice provision tucked into it, too. SB 371 also seeks to over-regulate abortion providers — requiring health clinics that prescribe the abortion pill to adhere to all of the same standards as surgical clinics, even though medication abortions are not surgical procedures — which threatens to shut down a Planned Parenthood clinic in the state.

“This bill is directly targeted to Planned Parenthood in Lafayette,” state Sen. Becker (R) pointed out in the debate on the floor. “When you do this, you’re not doing anything that will improve the health and safety of low-income women in the state of Indiana. All you’re doing is forcing them to go other ways — in particular, to the Internet — to get this same particular drug that you’re talking about regulating.”

Spurred by thousands of American women who were being injured due to faulty IUDs, President Gerald Ford signed the Medical Device Amendments of 1976 into law, granting the Food and Drug Administration (FDA) greater regulatory oversight regarding the safety and effectiveness of medical devices intended for widespread distribution. It was a historic consumer protection law intended to preserve public health and safety — but the legislation was also riddled with regulatory loopholes, particularly with respect to products that were already out in the market. Now, almost forty years later, Americans are still feeling the impact of the incomplete legislation as they encounter a multitude of common medical devices, including lethal products, that haven’t undergone adequate testing.

As The Atlantic reports, the medical device regulation bill contained lax provisions for classifying the safety of devices that are similar to products already available on the market, meaning that many contemporary devices do not have to undergo thorough testing simply because they were considered safe enough back in 1976:

The legislation created varying safety standards for devices that the FDA would deem as low, medium, and high risk. Medium-risk products, like surgical stitches, could be sold without first being tested on people under most circumstances, provided the device was “substantially equivalent” to one already on the market. For high-risk devices, like artificial hearts, companies were generally required to test their products in people and demonstrate to FDA that the products were safe and effective.

The law applied immediately to new types of devices and directed the FDA to retroactively classify existing ones, with one caveat: Products that were already on the market when the law passed would effectively be regulated as medium-risk until FDA officially classified them. The unfortunate result has been that some high-risk devices have won approval without being tested in people.

This interim solution was not supposed to last 37 years. Yet nearly four decades since Congress passed the Medical Device Amendments, the FDA still has not classified some of the temporarily “grandfathered” devices. As a result, potentially high-risk devices are continuing to reach the market without ever being tested in people.

The contemporary high-risk products that still have not undergone human testing due to the loophole include aortic balloons for heart surgeries and automated external defibrillators (AEDs). After thousands of faulty hip replacements caused a public health outcry over the last several years, Congress finally took action in 2012 to give the FDA more authority to re-classify the so-called “grandfathered” products. But while the FDA has taken action to re-label hip replacements, “19 grandfathered device types remain unclassified.”

Unfortunately, congressional procrastination on public health and safety measures is depressingly standard, as the FDA’s regulatory powers consistently lag behind until a crisis erupts to force lawmakers to make a change. Last year’s deadly deadly meningitis outbreak stemming from lax standards at a Massachusetts-area compounding pharmacy illustrates the trend perfectly. Lawmakers eventually responded to that crisis by introducing legislation to give the FDA more power to oversee the largely unregulated compounding pharmacy industry — but only after the outbreak resulted in the deaths of over 30 Americans, and the FDA director Margaret Hamburg begged a Senate health committee to give the agency more oversight.

Anti-choice Republicans are chipping away at reproductive rights from all angles, particularly on the state level. Often, lawmakers advance several different abortion restrictions simultaneously — as is currently the case in Arkansas and North Dakota — and it can be difficult to unwrap the rhetoric to figure out exactly what all of those proposed measures would mean for the women in their state. Underneath all the euphemisms intended to disguise Republican affronts to women’s health, here’s what anti-abortion lawmakers really mean:

1. Fetal pain laws

Nebraska was the first state to pass a 20-week ban on abortion, relying on the medically disputed assumption that fetuses can feel pain after that point. Since then, seven other states have followed suit and passed similar types of restrictions — which came to be known as “fetal pain” laws. But don’t be fooled. The idea that fetuses can feel pain at 20 weeks of pregnancy is junk science, even though the anti-abortion community continues to tout it as fact. In reality, fetal pain bans represent a dangerous step toward rolling back women’s constitutional right to an abortion. Under Roe v. Wade, legal abortion is guaranteed until the point of viability, which generally occurs around 24 weeks of pregnancy — but 20-week bans move the goalposts, seeking to narrow the window when women may legally terminate a pregnancy. Two fetal pain laws are currently being blocked in court for overstepping Roe, but anti-abortion lawmakers keep pushing them anyway.

2. Heartbeat bans

Heartbeat bans go even further than fetal pain measures do, seeking to outlaw abortions as soon as a a fetal heartbeat can be detected — which can occur as early as six weeks, before many women even realize they’re pregnant. Fetal heartbeat bills are clearly unconstitutional, since they would narrow women’s window to access legal reproductive services by about 17 weeks. Nonetheless, heartbeat measures popped in states across the country at the beginning of this legislative session. And it’s important to remember that this type of legislation would also necessitate an invasive, unnecessary transvaginal probe for women seeking abortions. Transvaginal ultrasounds are the only way for doctors to clearly detect a fetal heartbeat so early in a pregnancy.

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In constructing the sequester — a series of automatic, across-the-board spending cuts that will go into effect unless Democrats and Republicans can come to an agreement on the federal budget — lawmakers intended to design cuts that would be equally painful for Democrats and Republicans, by mandating cuts to both social programs and defense spending.

But the reality of the sequester cuts, which will begin taking effect this Friday unless Congress acts, is that they will actually have devastating effects on all Americans. Sequestration would have a disproportionate effect on some of the nation’s most vulnerable populations, particularly women and children, while still retaining wasteful military spending on some outdated projects. Here’s how the numbers stack up:

Melissa Boteach is the Director of the Half in Ten Campaign at the Center for American Progress Action Fund.

In a blow to Americans relying on Medicaid — the state-federal partnership public health insurance program that covers disabled and low-income Americans — the federal government on Tuesday reaffirmed to a California federal appellate court that, in the Obama Administration’s opinion, “states could cut Medicaid payments to many doctors and other health care providers to hold down costs in the program,” paving the way for massive state health care cuts that will further discourage doctors from treating low-income patients enrolled in the program.

Doctors, health care providers, and patient advocacy groups sued California in response to state health officials’ decision to cut already-low reimbursement rates for providers that treat patients on Medi-Cal — California’s Medicaid program — by an extra 10 percent. State leaders led by Gov. Jerry Brown (D) argue that the payment cuts are necessary for California’s fiscal security, especially as the state expands Medi-Cal to an addition 1.8 million Californians under Obamacare. But critics assert that the drastic payment cuts will make treating current and prospective Medi-Cal beneficiaries anathema to California care providers:

Medicaid is one of the fastest-growing items in state budgets. Cutting payment rates saves money for states and for the federal government, which will pay most of the costs for people who become eligible for Medicaid under the new law.

Health care providers said California’s payment rates were inadequate even before the cuts. They pointed to a federal study that said, “California stands out because of its very low Medicaid payment levels.”

In an interview, Dr. Paul R. Phinney, president of the California Medical Association, a plaintiff in one of the court cases, said: “Two-thirds of doctors in California cannot afford to participate in Medicaid because the rates are so low. The problem will only get worse if rates are cut as we move more and more people into Medicaid.”

The Administration’s endorsement of the Medicaid payment cuts underscores just how badly federal officials want states to take part in Obamacare’s Medicaid expansion. Formally blessing states’ abilities to “reasonably” lower their Medicaid physician payment rates is likely a concession aimed at luring reticent governors into accepting the expansion, since it will save both states and the federal government money. But while expanding Medicaid under Obamacare is crucial for the health and financial security for millions of low-income Americans, drastically lowering hospitals’ and physicians’ Medicaid reimbursements — which are already far less generous than Medicare reimbursements — is rife with risks.

Certainly, provider cuts are preferable to cutting special Medicaid benefits for the poor and disabled that are not available on lower-tier private insurance plans, especially in a state like California that has had its fair share of problems with providing adequate services to Medi-Cal beneficiaries. But California already has 6.8 million residents on Medi-Cal, including one in three Californian children and the majority of HIV-positive Californians. Payment cuts that discourage providers from treating these Medi-Cal beneficiaries will leave millions of Americans with few facilities to go to for their care, making them dependent on either free clinics, costly emergency room care, or forcing them to travel massive distances to find an accepting provider.

Reporting on a 2012 study finding that one in three American doctors won’t take new Medicaid patients, Wonkblog’s Sarah Kliff presciently wrote that that could spell trouble for states with historically low Medicaid reimbursement rates — such as California — that also wanted to expand Medicaid, since “fewer than 60 percent of providers accept new patients in the [Medi-Cal] program.” With Brown’s new Administration-endorsed payment cuts set to hit California’s safety net providers, that number has nowhere to go but down.

As promised, Arkansas Governor Mike Beebe on Tuesday vetoed an anti-abortion “fetal pain” bill. The measure will likely be pushed through without his consent, however, since the Republican-controlled legislature is able to override vetoes through a simple majority vote.

If overridden, the law will be among the most restrictive abortion bans in the nation. It would outlaw abortions after merely 20 weeks of pregnancy, based on the junk science that a fetus can feel pain after that point. Seven other states have similar 20-week restrictions in place, although two of them are currently being challenged in court.

As state legislatures begin their 2013 sessions, a flurry of new “ag gag” bills to protect factory farms from potential undercover whistleblowers have been introduced in 5 states. This week, the Indiana Senate is debating a proposal to criminalize taking photographs or videos inside an agricultural or industrial operation without permission.

Senate Bill 373 is the first of two ag gag bills introduced during Indiana’s 2013 session. New Hampshire, Nebraska, Wyoming and Arkansas are also considering them.

Since trespassing is already illegal, ag gag laws can only have one clear motive: to punish whistleblowers, advocates, and investigative reporters who use undercover recordings to reveal the abysmal conditions in which our food is produced. Undercover investigations have captured factory farms all over the country abusing livestock, passing off sick cattle as healthy, and discharging unregulated amounts of animal manure, which the US Geological Survey identified as the largest source of nitrogen pollution in the country.

The bill’s author, Sen. Travis Holdman (R), added a provision exempting anyone who turns over their video or photos to law enforcement within 48 hours — as long as they do not also share the footage with non-law enforcement, such as media or an animal rights group. But, as the Indy Star points out, many exposés are “undertaken precisely because the authorities failed to do their job. Sometimes, they have spotlighted conditions that were not illegal but were disturbing enough to inspire new laws.”

Indeed, factory farms have largely escaped regulatory and legal scrutiny. Last year, the Environmental Protection Agency abandoned an effort to require these operations to report even basic information like location, number of animals, and amount of manure discharged. Meanwhile, the meat lobby’s grip on lawmakers is so powerful that the USDA was pressured into apologizing for an internal “Meatless Monday” last year by Sen. Chuck Grassley (R-IA) and Rep. Steve King (R-IA), who claimed the optional vegetarian day was a full-scale attack on agriculture.

One USDA inspector even had his job threatened after he tried to report egregious violations at a California slaughterhouse. He then tipped off the Humane Society, which released an infamous video of employees torturing and slaughtering downer cows (sick cows deemed “unfit for human food” by the USDA). The video triggered the largest beef recall in U.S. history and resulted in an unprecedented $500 million penalty.
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New Jersey Gov. Chris Christie (R) has accepted Obamacare’s optional expansion of the Medicaid program, which will extend insurance coverage to an additional 300,000 low-income people in the state. As Republican opposition to the health care reform law finally begins to wane, Christie is the eighth GOP leader to agree to expand the Medicaid program under Obamacare — and the first potential 2016 presidential contender to embrace that provision.

The governor announced his decision at a state budget address on Tuesday. Although Christie remains a staunch Obamacare opponent — and has refused to set up a health insurance marketplace, the law’s other major state-level provision — he explained that expanding Medicaid represents a smart financial decision for his state. Thanks to the increased federal funding allocated for the states that choose to add more low-income residents to their Medicaid rolls, New Jersey will reap up to $300 million in the upcoming budget year.

“It’s simple. We are putting people first,” Christie explained in his address. “We have an opportunity to ensure that an even greater number of New Jerseyans who are at or near the poverty line will have access to critical health services beginning in January 2014.” The governor added that the federal government’s funding toward the public insurance program will mean that “expanding Medicaid will ensure New Jersey taxpayers will see their dollars maximized.”

That position is resonating with a growing number of deeply conservative Republicans. Just last week, Florida Gov. Rick Scott — who has been one of the health reform law’s most vehement critics — also announced his support for Obamacare’s Medicaid expansion. GOP governors in Arizona, Michigan, New Mexico, North Dakota, Ohio, and Nevada have also come out in favor of expanding Medicaid, which leaves nine Republican leaders who are still making up their minds about whether to increase the eligibility levels for their programs.

But the larger Republican establishment, which has increasingly moved further to the right, may not be particularly receptive to Christie’s decision. The governor has not been invited to speak at this year’s Conservative Political Action Conference because he is “simply not a conservative in the eyes of organizers” — largely, as the National Review suggests, because of his positions on Medicaid and gun violence prevention.

President Obama’s health care reform law takes big strides to eliminate the gender disparity in health costs, particularly by prohibiting most insurance companies from “gender rating” — the practice of charging women more for their coverage simply based on their gender. But that provision doesn’t apply to long-term care insurance, an area in which women may soon be charged higher premiums than their male counterparts for the exact same type of coverage.

Even though Obamacare will put an end to gender discrimination in the vast majority of insurance plans, the long-term care insurance industry isn’t required to cease the practice. And the industry is beginning to take advantage of that. Kaiser Health News reports that the nation’s largest long-term care provider has announced it will begin setting its prices by gender as early as this spring, a move that move may encourage the rest of the long-term insurance industry — which has already been hiking up its premiums over the past several years — to do the same:

Women’s premiums may increase by 20 to 40 percent under the new pricing policy, said Jesse Slome, executive director of the American Association for Long-Term Care Insurance. The average annual premium for a 55-year-old who qualified for preferred health discounts and bought between $165,000 and $200,000 of coverage was $1,720 last year, according to the association.

Experts say they expect other long-term-care insurers will soon follow suit.

Long-term-care insurance provides protection for people who need help with basic daily tasks such as bathing and dressing. It typically pays a set amount for a certain number of years — say, $150 daily for three years — for care provided in a nursing home, assisted living facility or at home. Never a very popular product with consumers, many of whom found it unaffordable, in recent years the industry has struggled and many carriers have raised premiums by double digits or left the market.

Women typically live longer than men — and often end up becoming the primary caregivers for their husbands, which reduces those men’s need for long-term insurance care. But when women’s health eventually devolves, they often don’t have a partner who can provide that type of care for them, and they’re stuck relying on insurance coverage. That’s why women typically have much higher claims for long-term care services, and why insurance companies want to be able to charge them more.

But women also tend to have fewer economic resources than men do, since an enduring wage gap accumulates over time to leave older women with significantly less wealth. Over the course of a 40-year working career, the average woman loses out on an estimated $431,000, and the annual wage gap jumps to about $14,352 in the five years before retirement. Requiring women to pay more for health care in the final years of their life could be a significant drain on their resources, particularly for single women, and ultimately prove unaffordable.

And ultimately, charging women more won’t address the fact that the country’s long-term care industry is currently an unsustainable model. The health care reform law originally included a provision to help address the long-term care crisis in the United States — but the Obama Administration decided the Department of Health and Human Services didn’t have enough authority to implement it, and the GOP has simply pushed to repeal it rather than working to craft a better policy. The fiscal cliff deal finally did away with it for good, but lawmakers still haven’t worked out a better system for taking care of Americans’ long-term care needs — in an equitable way that’s affordable for both women and men.