– Zachary Bernstein

The debate grew heated, and Deputy House Majority Leader C. Todd Gilbert (R) even suggested that women undergo abortions to maintain their “lifestyle.” He later apologized for his remarks:

“Abortion is a sad and deeply serious occurrence,’’ Gilbert said in a statement. “Individuals on both sides of this issue agree that it is tragic for all involved. I recognize that few women undergo the procedure lightly. It leaves scars, both mental and physical, that can last forever. I regret that my comments earlier today on the House floor were insensitive to that reality.’’

Gilbert, who opposes abortion rights, shocked opponents of a bill that would require women to undergo an ultrasound before an abortion when he said: “In the vast majority of these cases, these are matters of lifestyle convenience.”

The state Senate already approved the ultrasound bill, so now it goes to Gov. Bob McDonnell (R), who has already said he will approve the measure.

But two studies have already shown that ultrasounds do not influence women’s decisions on abortions. It is unclear if the GOP-controlled Senate will also approve the personhood measure. Last year, when Democrats controlled the Senate, they voted down a similar measure.

– Zachary Bernstein

Today, the Senate will hold a vote on a Republican substitute introduced by Sen. Roy Blunt (R-MO), which would allow any and all insurers and employers to deny their employees health benefits and services required by federal law based on their personal religious or moral objections. The measure has 37 co-sponsors — including the GOP leadership, women Republican Senators Lisa Murkowski (AK), Kay Bailey Hutchison (TX), Kelly Ayotte (NH), Democrat Ben Nelson (NE), and Republican Scott Brown (MA). Brown has supported expansive conscience protections for religious organizations throughout his legislative career, but voted for a tougher contraception mandate as a Massachusetts state representative in 2002 and approved of a law requiring all hospitals — including Catholic institutions — to provide emergency contraception to rape victims in 2005.

After defending Obama’s rule last year, Democrats are now on the offensive. Sens. Barbara Boxer (D-CA) and Patty Murray (D-WA) have derided Blunt’s measure as “extreme” and “dangerous,” claiming that “It puts politics between women and their healthcare.” Sen. Jeanne Shaheen (D-NH) warned, “This would gut the protections that were established in the Affordable Care Act and open a Pandora’s box that allows employers to deny coverage for virtually anything they might object to” and yesterday, Massachusetts Senate candidate Elizabeth Warren told the Washington Post’s Greg Sargent that amendment would permit insurers or employers to discriminate against women:

“I am shocked that Senator Brown jumped in to support such an extreme measure,” Warren told me by phone just now. “This is an all new attack on health care. Any insurance company could leave anyone without health care, just when they need it most.” [...]

“This is an extreme attack on every one of us,” Warren said. “It opens the door to outright discrimination. It would let insurance companies and corporations cut off pregnant women, overweight guys, older Americans, or anyone — because some executive claims it’s part of his moral code. Maybe that wouldn’t happen, but I don’t want to take the chance.”

Indeed, under the measure, an insurer or an employer would be able to claim a moral or religious objection to covering HIV/AIDS screenings, Type 2 Diabetes treatments, cancer tests or anything else they deem inappropriate or the result of an “unhealthy” or “immoral” lifestyle. Similarly, a health plan could refuse to cover mental health care on the grounds that the plan believes that psychiatric problems should be treated with prayer.

Individuals too can opt out of coverage if it is contrary to their religious or moral beliefs, radically undermining “the basic principle of insurance, which involves pooling the risks for all possible medical needs of all enrollees.” As the National Women’s Law Center explains, Blunt’s language is vague enough that “insurers may be able to sell plans that do not cover services required by the new health care law to an entire market because one individual objects, so all consumers in a market lose their right to coverage of the full range of critical health services.” As a result, a man “purchasing an insurance plan offered to women and men could object to maternity coverage, so the plan would not have to cover it, even though such coverage is required as part of the essential health benefits.”

Significantly, two Republican women senators — Olympia Snowe (ME) and Susan Collins (ME) — have come out in support of Obama’s modified contraception rule and may oppose Blunt’s measure.

Read the full amendment here.

Fatima Najiy contributed to this post.

Catholic leaders will fight Obama’s contraception modification: “The top U.S. Catholic bishop vowed legislative and court challenges Tuesday to a compromise by President Barack Obama to his healthcare mandate that now exempts religiously affiliated institutions from paying directly for birth control for their workers, instead making insurance companies responsible. Cardinal-designate Timothy Dolan, who heads the U.S. Conference of Catholic Bishops, said in an interview with The Associated Press that he trusted Obama wasn’t anti-religious and intended to make good on his pledge to work with religious groups to fine-tune the mandate.” [AP]

Lawmakers close to SGR deal: “Federal lawmakers on Tuesday evening inched closer to an agreement on a short-term solution to Medicare’s sustainable growth-rate formula for physicians. If Congress does not act by Feb. 29, doctors who participate in the federal healthcare program will face a 27.4% cut in their Medicare reimbursement.” [Modern Healthcare]

Health industry critical of Obama’s budget: “Tom Nickels, senior vice president of federal relations at the American Hospital Association, said providers, who already are dealing with payment cuts through regulatory and legislative changes, must also face nearly $130 billion in cuts over 10 years when sequestration kicks in next year. “It ignores the reality that we’re all already being cut 2%,” Nickels told Modern Healthcare. “And now they’ve cut on top of that.” [Modern Healthcare]

Alaska takes step towards exchanges: “Alaska has opposed the federal health law so adamantly that it is the only state that chose not to even apply for a $1 million grant the federal government was passing out to states to plan a health insurance exchange. But that doesn’t necessarily mean there won’t be an online marketplace to buy insurance in Alaska.” [Kaiser Health News]

Iowa advances ultrasound bill: “A doctor would be required to perform an ultrasound on a woman seeking an abortion and give the woman an opportunity to view images of her fetus under legislation heard Tuesday in a House subcommittee. The bill, House File 2033, will be advanced to the Human Resources Committee.” [Des Moines Register]

Lee seeks to ban abortions in DC: “Sen. Mike Lee has introduced legislation that would ban abortions in the District of Columbia for women who have been pregnant longer than 20 weeks. The bill, introduced Monday, would add D.C. to a list of five conservative states that have a similar threshold, the point some doctors say an unborn child has developed the ability to feel pain.” [Salt Lake Tribune]

WALSH: If I were the Speaker, starting last year, every month we would have voted to repeal ObamaCare. I would have pulled ObamaCare up on the floor of the House yesterday.

Watch it:

Walsh’s scheme is an exercise in both redundancy and futility several times over, because no matter how many times the House passes a repeal (it only takes one time to matter), the Senate, controlled by Democrats, is not going to do the same. And even if they did, President Obama would certainly veto a bill killing his signature legislative accomplishment.

Meanwhile, Walsh would continue to enjoy his government healthcare while wasting everyone else’s time.

While it’s unclear if Nickless is calling for literal violence in opposition to the mandate — something that’s difficult to square with Jesus Christ’s teaching that “if someone strikes you on the right cheek, turn to him the other” — or merely calling for strong resistance, his comment underscores the extreme rhetoric with which some religious conservatives have responded to the Obama Administration’s effort to ensure that all women have access to contraception. Some recently told Sean Hannity they’d be willing to die before complying with the law.

At all levels of government there has been a serious push for increasing access to food among low income households and fostering more nutritious eating habits in communities and schools.
Last July, First Lady Michelle Obama and the Partnership for a Healthier America secured pledges from Wal-Mart, Walgreens, SuperValu and several other stores to open or expand stores in “food deserts”, bringing healthy affordable food to approximately 10 million people over the course of five years. Any specific information on how many will be served in CA?

That same month the First Lady also announced the California FreshWorks Fund, a public-private partnership loan fund with $264 million available to support grocery stores and other healthy food retailers in low-income, underserved communities in California. The California Endowment and a team of partners that include banks, grocers, health care providers, and nonprofits lead this initiative. Modeled after a successful program in Pennsylvania, this loan fund provides grants to healthy food retailers willing to locate stores in “food deserts”, areas lacking access to fresh, healthy food.

On Feb. 1, the First Lady spoke at a community event in Los Angeles to celebrate the progress that the California FreshWorks Fund has made in bringing affordable and healthy food to neighborhoods around the city. As one of its initial projects, the California FreshWorks Fund committed more than $20 million in funding to Southern California grocer Northgate Gonzalez Markets for its first three projects: a San Diego location as well as stores in Inglewood and South Los Angeles. The President and CEO of the California Endowment, Robert K. Ross, MD, also spoke at this event and enthusiastically stated, “we all have a shared interest in ensuring our neighborhoods, grocery stores and school cafeterias contribute positively to the health of our communities. Today’s announcement marks the beginning of what we hope will be a robust effort to expand access to nutritious food for all Californians!”

These commitments are a step in the right direction in the effort to combat the country’s obesity and hunger epidemics. Approximately one in four children in the U.S. live in a household that experiences hunger. Additionally, 30 percent of children in the U.S. are overweight or obese and among African Americans and Latinos the number soars to an estimated 40 percent.

Although hunger and obesity are oftentimes viewed as two distinct problems, they are deeply interconnected. Hunger and food insecurity are key contributors to obesity as low-income Americans are forced to rely upon high calorie, low nutrition foods to quell hunger pangs. Notably, studies have consistently demonstrated the lack of supermarkets and other stores selling healthy, affordable food in low-income communities as compared to wealthier ones. Adults in California neighborhoods with low access to healthy food are 20 percent more likely to be obese than those in higher-access neighborhoods, increasing their risk of developing chronic diseases. The California Fresh Works Fund website features a very useful interactive map that displays “Grocery Gap” statistics for various counties throughout the US and can be broken down into detailed indicators. The California FreshWorks Fund was created to tackle these food access concerns, while also addressing additional challenges faced by communities in so-called “food deserts”. In addition to improving community health, drawing grocery stores into “food deserts” also creates opportunities for economic development. Grocery stores create jobs (an estimated 49 to 120 new jobs per store), attract other small businesses to the area, and increase the surrounding residential real estate values.

Additional benefits include increased property values in the surrounding communities and increased income and property tax. This increased economic activity and property value help relieve pressure on state and local budgets and increase community sustainability.

California’s Freshworks Fund serves as a model for an innovative public-private partnership loan fund with the potential to increase access to healthy and affordable food throughout the state. This new program is proving itself as a vital component in California’s fight against hunger and obesity, and as an important force in strengthening the economies of affected communities.

Katie Wilczak, CAP CA Intern, contributed to this piece.

The Affordable Care Act is expected to stabilize the employer health insurance market while opening up options for people who are uninsured through the state insurance exchanges. In 2009, more than 50 million Americans were uninsured, but estimates show that the Affordable Care Act will reduce the number of uninsured by 32 million once it is fully implemented.

GINGRICH: First of all, I don’t know that he made a big shift. It’s a clever maneuver that may actually be worse, not better. I want to explore it carefully. A number of leading Catholic intellectuals believe this is actually worse. It’s certainly worse as a matter of conscience.

Watch it:

Gingrich’s position that the accommodation is even “worse” than the original plan seems to put him even farther to the right that his fellow Republican presidential candidates on the issue who have characterized the change as “another deception.” And it’s an especially bold claim considering that Gingrich doesn’t explain why he think the new policy is worse, as it will require insurance companies, instead of religiously-affiliated employers, to provide an option for contraception coverage

The “Catholic intellectuals” Gingrich mentions is likely a reference a group who signed onto an open letter opposing the mandate. One of the letter’s top signers, Robert George, is a prominent anti-gay Catholic activist associated with the National Organization for Marriage. Another top signer, Mary Ann Glendon, is a Mitt Romney supporter who has gone to so far as to contest the use of condoms to prevent the spread of HIV. “The Holy See in no way endorses contraception or the use of condoms, either as a family planning measure or in HIV/AIDS prevention programs,” she said.

But Gingrich seems to be putting himself even farther to the right than the signers of the letter, as even they don’t seem to think the accommodation is worse than the original decision, though they are opposed to both.

Most Republicans are not satisfied with the modification, however, and are co-sponsoring legislation that would significantly broaden the conscience exclusion. On Monday night, Sen. Scott Brown (R-MA) joined the pack, with a spokesperson telling the Washington Post’s Greg Sargent that the senator “appreciates President Obama’s willingness to revisit this issue, but believes it needs to be clarified through legislation” that would permit any employer or insurance plan to exclude any health service, no matter how essential, from coverage if they morally object to it.

But Massachusetts already requires insurers to carry contraceptive coverage for women and Brown voted for the provision as a member of the Massachusetts House on Jan. 30, 2002, ThinkProgress has learned. At the time, the Catholic Conference of Massachusetts, lobbied against the measure and urged lawmakers to adopt an amendment exempting organizations that are affiliated with the Catholic church or have a moral objection to contraception. Brown supported that provision, but once it failed in a vote of 106 to 49, he voted ‘YES’ on the underlying bill, which only exempted “an employer that is a church or qualified church-controlled organization” from offering birth control:

Since Obama’s new federal standard would allow church-affiliated nonprofits to eschew birth control coverage, it could offer greater conscience protections to Massachusetts’ Catholic colleges, universities, and hospitals. For instance, if Boston College is required to provide birth control under the Brown-approved law, it could drop the coverage — and leave the matter to its insurer — under Obama’s regulation.

Interestingly, Brown also voted for a 2005 bill mandating hospitals to offer emergency contraception to rape victims, even after lawmakers defeated his amendment to allow religious hospitals to opt out of the requirement. Brown split with then-Gov. Mitt Romney on the matter and joined the legislature in overriding his veto.

Brown’s office did not immediately respond to ThinkProgress’ request for comment.

UT-4 Republican candidate Stephen Sandstrom

On Friday, Santorum told the Conservative Political Action Conference that he didn’t think health insurance plans ought to cover contraception because birth control “costs just a few dollars.” Santorum dismissed contraception as “not a critical economic need” and therefore wasn’t one of the “things you need insurance for.”

ThinkProgress asked Sandstrom about Santorum’s comments at CPAC the following day. Sandstrom, who describes himself as a “stalwart conservative,” nevertheless said Santorum was wrong to say that no insurance plans should cover birth control. Sandstrom argued that if individuals want contraception coverage or companies want to offer it, “then that’s fine.”

KEYES: Now some people are willing to go even a little bit further on the issue like former Sen. Santorum yesterday said that he didn’t think insurance plans should be covering birth control at all. It just wasn’t something that should fall under the purview. What do you think, do you think he’s right on that?

SANDSTROM: No, I differ a little bit. I think it’s okay if an individual company makes that decision or an individual person wants insurance, they want to provide that option for people then that’s fine. But it should be the company making that decision, not the federal government deciding how they do it, and the individual making that decision.

Santorum isn’t the only GOPer currently poo-pooing the cost of birth control. On Friday, Rep. Tom Price (R-GA), the number five Republican in the House of Representatives, told ThinkProgress that “there’s not one woman” who doesn’t have access to birth control.

In fact, birth control can cost women over $850 in the first year of their prescription. Combined with fees from the doctors visit, the out-of-pocket expense could rise to over $1,200 for uninsured women. Such price tags are prohibitive for millions of women; a recent survey found that one in three women voters have struggled to afford contraception at some point.

$864 million for health reform: President Obama’s budget includes $864 million to get a key element of his healthcare reform law off the ground. The law requires health insurance exchanges to be in place in all 50 states by Jan. 1, 2014. States that want to run their own exchanges must pass muster with the federal government by the end of 2013; the federal government will operate a default exchange in states that fail to launch their own.” [The Hill]

Obama beefs up primary care coverage: “The Obama administration announced Monday that it is making $9.1 million in National Health Service Corps awards available to medical students who are willing to serve in underserved areas. The funding was made possible by the 2010 healthcare reform law.” [The Hill]

Doctors left out: “House Republican leaders announced they will introduce a bill to extend a middle-class payroll tax holiday in legislation that won’t include a solution to Medicare’s sustainable growth-rate formula for physicians.” [Modern Healthcare]

Why Catholic leaders say yes to Viagra: “If health insurance plans offered by Catholic-sponsored entities refuse to cover contraceptives for women because of the religion’s moral teachings banning artificial birth control, do they cover Viagra for men?…Procreation is something the Catholic church encourages. And Viagra and other erectile dysfunction drugs can be of help.” [NPR]

Washington House OKs pro-choice bill: “Washington state lawmakers moved forward Monday with bills on insurance coverage for abortions, facial recognition for state IDs and fees for vehicle towing…Supporters said the bill would ensure that existing abortion coverage will be preserved once federal health insurance rules come into effect under the Affordable Care Act in 2014.” [AP]

Virginia advances ultrasound bill: “House of Delegates Republicans have rejected a last-ditch bid by Democrats to allow women seeking abortions to opt out of an invasive ultrasonic procedure under anti-abortion legislation set for a final House vote Tuesday. Legislation that has advanced on the strength of a GOP majority would force women to undergo a “transvaginal ultrasound” that produces fetal images.” [AP]

Like any budget, Obama’s is complicated, containing investments and cuts to various programs. With that in mind, ThinkProgress compiled 10 facts about the Obama budget based on the White House fact sheet and other reports:

1. The budget includes $350 billion in short-term measures to encourage job growth, including $50 billion in immediate infrastructure investment, $30 billion to rebuild schools, and year-long extensions of the payroll tax holiday and unemployment insurance.

2. The implementation of the Buffett Rule and the repeal of the Bush tax cuts for the wealthy helps reduce the deficit by $1.5 trillion over the next 10 years.

3. For every $1 in new revenue from those making more than $250,000 per year and from closing corporate loopholes, the budget has $2.50 in spending cuts including the deficit reduction enacted over the last year.

4. The total budget reduces the deficit by $4 trillion over the next decade.

5. Obama preserves the maximum Pell Grant award, a key difference from the GOP budget, and makes permanent then Americans Opportunity Tax Credit, which helps 9 million families afford the costs of college.

6. Unlike the last two GOP budgets, Obama’s budget protects Medicare and Medicaid from structural changes, and through small tweaks, saves $360 billion from those programs.

7. States will receive $30 billion in aid to prevent further layoffs of firefighters, teachers, and police officers, some of the hardest-hit workforces in the nation.

8. The budget eliminates 12 tax breaks to oil, gas, and coal companies, saving $41 billion over 10 years.

9. Obama preserves planned cuts to the Defense Department negotiated in the debt limit deal last August.

10. The budget maintains goals of putting one million electric vehicles on the road by 2015; doubling share of electricity from clean energy sources by 2035; and reducing buildings’ energy use by 20 percent by 2020.

As the Center for American Progress’ Michael Linden notes, Obama’s budget is far from perfect. It’s spending caps are too low, it’s defense cuts are too small, and it contains less new revenue than bipartisan plans like Simpson-Bowles and Rivlin-Domenici. But it prioritizes job creation and economic development and keeps America on the path to recovery, something Republican plans, unfortunately, fail to do.

Ready for the bighouse

Rich Land of the Southern Baptist Convention hit the two poles of overly emphatic rhetoric in one breath, first invoking the Holocaust by reciting Martin Niemöller famous poem “First they came…,” before comparing himself to Martin Luther King Jr. by saying he was ready to “follow in the footsteps” of the civil rights giant by dispatching letters from jail, if need be.

Hannity responded by asking the baker’s dozen religious leader, “how many of you would be willing to go to jail over this?” — all but three or four raised their hands.

But Father Jonathan Morris, a Fox News contributor and Catholic priest in New York City, one upped Land, saying he was ready to put his life on the line. “It’s very clear, people have died for those things that are absolutely essential for their faith. It’s not a question of are you willing to go to jail, it’s if I’m asked to do something that goes against my conscious, I’d better be willing to die for that.” He continued, “If I’m not willing to die for that, what am I standing up for?” Watch it:

Conservative commentator Michele Malkin also reached for the Holocaust invocation on this issue, and pastor Rick Warren, who spoke at Obama’s inauguration said he would be willing to go to jail.

But this is a silly offer of self-sacrifice, as there is no actual threat of jail time. While the final regulations have yet to be written, the penalty will be financial — not criminal — and regulated by the IRS, likely about $1,000 per violation, according to an expect contacted by ThinkProgress. As Andrew Sullivan notes, by their, Rick Warren should already be in jail, as he’s a resident of California, which has a stricter contraception mandate than the new federal one.

Under Obama’s approach, for instance, higher-income seniors would pay more for doctors visits and prescription coverage beginning in 2017 and all new enrollees will pay a $25 deductible as part of their Part B premiums. But for the most part, the budget is similar to the administration’s September 2011 deficit reduction plan and recoups the greatest savings from drug rebates and modernizing provider payments to achieve greater efficiency. Here is a chart showing where all the savings come from:

Given that Ryan’s Medicare savings don’t kick in until 2022, it’s hard to make a direct comparison with Obama’s proposal. But suffice it to say, Ryan would cut about 1.4 trillion from Medicaid alone and another $30 billion in net Medicare savings using last year’s 10-year budget window.