Public health advocates and doctors from the University of New Mexico Health Sciences Center have begun work on an ambitious new project in which mental health experts will electronically train primary care doctors how to identify and treat mental and substance abuse disorders. The groups say the initiative will help more Americans — particularly those living in rural and medically under-served regions — get critical mental health treatment.

The Robert Wood Johnson Foundation (RWJF) and General Electric’s philanthropic arm is sponsoring a new mental health clinic in New Mexico that will use the electronically coordinated arrangements, which are based on an existing University of New Mexico innovation called Project ECHO (Extension for Community Healthcare Outcomes). Project ECHO is a form of “telemedicine” where specialists hold weekly, virtual training sessions where “primary care doctors, nurses, physicians’ assistants, and other clinicians from multiple sites present their cases to the specialist teams and to each other, discuss new developments relating to their patients, and determine treatment,” according to a fact sheet on the project.

A combination of high costs, spotty access, and societal stigma prevents most Americans from pursuing mental health treatment, even if they desperately need it. In rural, poor, and isolated regions, the problem is even worse. Over 85 percent of areas that the federal government classifies as “mental health professional shortage areas” are in rural communities, and “only in rural America did the National Advisory Committee on Rural Health find entire counties with no practicing psychiatrists, psychologists, or social workers,” according to a 2009 report by the Center for Rural Affairs. That means Americans living in rural regions who suffer from mental illness must travel extensive distances or forgo mental care altogether.

By spreading ECHO training technique to mental health care, experts hope that primary care doctors — who aren’t always well-versed in mental health issues — will soon be able to provide rural New Mexican families with mental checkups and treatment in the convenience of their own towns. “This approach with Project ECHO will bring mental health care to patients in their home communities with local clinicians,” said Bob Corcoran, president and chairman of the GE Foundation, in a press release. “We think this will not only improve access to mental health care, but ultimately improve overall well-being and quality of life for these patients and their families.”

If the experiment proves as successful as previous efforts to manage Hepatitis C and chronic conditions through the ECHO model, RWJF and the GE Foundation hope to spread it across the country.

Private, nonprofit efforts such as this may be necessary in the absence of federal legislation with America’s broken mental health system. Although many lawmakers promised to make mental health care issues a focus after the tragic shooting massacre in Newtown, Connecticut, bipartisan mental health and community resource bills have stalled in Congress. President Obama led a day-long conference earlier this month in which he urged Americans to “bring mental illness out of the shadows” and establish resources for all Americans to get help with mental issues.

Limiting welfare benefits to those who successfully manage to find a job within a set time period puts those low-income individuals at a slightly increased risk of dying sooner, according to a new study. The study’s authors suggest that the higher death rates may stem from the fact that the current welfare system does not adequately provide for the Americans living in extreme poverty.

Led by Columbia University’s Dr. Peter Muennig, a team of researchers tracked Floridians on welfare over nearly two decades. The researchers were interested in examining health outcomes in the time period after former President Clinton’s 1996 welfare reform bill — which hoped to shrink welfare rolls by tying benefits to employment, spurring low-income recipients to take steps to improve their financial standing — was signed into law. And they found that death rates were a half percent higher among welfare recipients who were pushed to find employment or face losing their benefits, as compared to those who received unrestricted benefits regardless of their employment status.

Muenning told Reuters Health that while some of the study’s participants may have successfully found employment and begun to earn more money, “others lost their lifeline and had to fall back on already poor family members and friends to eat and get shelter.”

Among the group that faced a time limit on their benefits unless they secured employment, significantly more people did get jobs. But Muenning and his colleagues found that few of those people actually made more money at their jobs than the total income that the other, unrestricted group received from their welfare benefits and other supplements. And half of the people in the time-limited group couldn’t find a job during much of the program.

The study’s authors noted that there needs to be more research in this area in order to draw strong conclusions about the health impacts of welfare reforms. But their findings align with other studies that have found that even though the 1990s-era reforms successfully shrunk the welfare rolls, they also led to a huge spike in extreme poverty. As the economic downturn has made the job market sluggish, the number of low-income Americans who need federal assistance has increased even as the availability of those benefits has shrunk.

Researchers have documented the serious health effects of other economic policies, too. Stringent austerity policies in Europe and the United States are literally killing people by limiting medical resources, pushing more people into homelessness, curtailing access to health care, and causing an uptick in alcoholism and depression. And the recent sequester cuts are already hampering cancer care, preventing federal agencies from conducting food inspections, and slowing medical research.

Over the past two weeks, Wisconsin Republicans have fast-tracked several anti-abortion measures they hope to squeeze in before this year’s legislative session ends. Gov. Scott Walker (R) has already thrown his support behind some of the abortion restrictions — but the same isn’t true for any of the major medical associations in the state.

As the Capital Times notes, Wisconsin’s proposed abortion restrictions — which include a bill that would shut down abortion clinics and mandate potentially invasive ultrasound procedures, a bill to prevent abortions based on gender, and a bill to prevent insurance coverage of abortion in Obamacare’s health insurance marketplaces — don’t have the backing of leading doctors’ groups. The Wisconsin Medical Society, the Wisconsin Association of Local Health Departments and Boards, the Wisconsin Academy of Family Physicians, the Wisconsin Hospital Association, and the Wisconsin Public Health Association have all declined to endorse the measures.

Susan Armacost, the legislative director for Wisconsin Right to Life, told the Capital Times that the doctors and medical leaders who haven’t announced their support for the abortion restrictions are being “short-sighted.”

“We would remind the medical community that abortion is unlike any other medical procedure. Its only goal is to destroy a human life,” Armacost said. “I would think if they stopped to think about this, they would realize it is not like setting a broken wrist or taking out appendix.”

Aramcost’s comments reflect the anti-abortion community’s push to segregate abortion services from the rest of women’s health care, an indirect method of restricting women’s access to reproductive health services. That tactic that has been largely successful, as many states lack adequate numbers of abortion providers now that mounting piles of restrictions have made it too difficult to practice abortion care.

But the professional medical community stands in opposition to this characterization of women’s health. Earlier this month, the American College of Obstetricians and Gynecologists, a national organization representing thousands of women’s health experts, came out against state-level abortion restrictions that interfere in their work. And as anti-abortion legislation has gotten more extreme over the past several years, increasing numbers of nonpartisan medical associations have chosen to wade into politics by expressing their opposition to abortion bills.

In April, Virginia’s Board of Health approved new regulations intended to force abortion clinics to shut down. It’s already working: later that month, a 40-year-old abortion clinic in the state announced that it would be closing its doors. But now, women’s health advocates are fighting back.

The Falls Church Healthcare Center has filed the first lawsuit challenging the burdensome clinic restrictions. In its suit, the clinic points out that there’s no good reason to hold abortion providers to medically unnecessary standards that will force them to make expensive renovations, like widening their buildings’ doorways. The Falls Church organization says that the new, tighter regulations will require it to spend $2 million on renovating its century-old clinic building.

“We are committed to providing women’s healthcare to the under-served population in northern Virginia,” Rosemary Codding, the center’s director, told the Times Dispatch. “They’re taking away the rights of these women, and I have to stand up for them.”

The organization’s lawsuit also alleges that Attorney General Ken Cuccinelli (R), who is currently Virginia’s GOP candidate for governor, fed the state’s supposedly nonpartisan health board false information about the regulations. Falls Church Healthcare Center believes that the anti-choice lawmaker told board members that they didn’t have the legal authority to exempt existing clinics from the new law, even though that’s not the case. Other reports have suggested that Cuccinelli essentially threatened board members into approving the new rules.

Leveling burdensome regulations on abortion providers, with the ultimate goal of forcing clinics to shut down when they’re unable to comply, is a popular anti-choice tactic to indirectly attack women’s reproductive rights. Medical professionals agree that these type of laws — known as the Targeted Regulation of Abortion Providers, or TRAP — aren’t actually necessary to ensure women’s safety. “We’ve been re-inspected twice, and we have a license to operate through 2014,” Codding said, pointing out that the Falls Church clinic is already providing safe care to women and doesn’t need to make costly updates to its facility.

The American College of Obstetricians and Gynecologists, a national doctors’ group representing thousands of OB-GYNs across the country, recently issued an official statement criticizing TRAP laws for “imposing a political agenda on medical practice.”

As anti-rape protests have erupted over the past week in the Indian state of West Bengal, police arrested 13 members of a women’s rights group on Thursday. The protests were sparked by the gang rape and murder of a college student, and follow two other high-profile cases of rape in the state.

Anti-rape protests began last December and have been sustained since then. Protests have occurred across West Bengal and particularly in Kolkata, the state’s capital and the country’s third largest metropolitan area, and have been focused against the state government for not doing enough to crack down on violence against women. According to local media, residents’ concerns of insecurity for women have been routinely ignored by the government. In a sign of protest, many students stopped attending school or college and joined the demonstrations instead.

Thirteen of the protesters were arrested as they made their way towards the home of West Bengal Chief Minister Mamata Banerjee, where they intended to give her a letter expressing concern over violence against women. They were stopped when they were still several hundred meters away from the Chief Minister’s home and detained for over eight hours. Police also cited the disruption of traffic as a reason for breaking up the protest.

“It is the beginning of our movement. We won’t give up so easily,” said Anuradha Kapoor, an activist in the civil rights group Maitree and one of those arrested. She told local newspaper Firstpost, “The state of women’s security in terrible. It has been like that for a long time now and we elected a new government for a reason. However, they are in complete denial of the situation and when you protest, this is what you get.”

On June 8, a 20-year-old college student’s body was found lying near a river near the outskirts of Kolkata after she had been gang-raped and murdered. The woman was on her way back home from taking an exam when she was apparently abducted, raped, and killed by a group of men. Six arrests have been made in connection to the incident. Three days later, a 14-year-old girl was raped and killed in the town of Gede, 90 miles away.

The state government has also come under fire after the National Crime Records Bureau released its annual report on crime statistics, pegging West Bengal as the state with the highest incidence of crimes against women, accounting for over 12 percent of the nation’s whole. Chief Minister Banerjee contested the Bureau’s statistics, a reaction which activists have called “callous,” and a reason for increased protests against Banerjee’s government.

Tourism in India has suffered in 2013 as multiple cases of rape have dominated headlines.

When activists at Dartmouth University disrupted an event for prospective students in April, they said they wanted to pressure their university to take racism, sexism, and sexual assault more seriously — and they wanted their administrators to start punishing serial rapists. After the university administration cracked down on the protesters, one of the participants told ThinkProgress, “The fact is that Dartmouth is punishing protesters who are very visible, but won’t punish students who commit assaults.”

Although the campus protesters received some serious backlash from some of their peers — including rape and death threats — for pointing out some of the shortcomings in their university’s sexual assault policy, their statements weren’t hyperbolic. Some of the participants in the protest were survivors of sexual assault, and some of their assailants haven’t faced adequate punishment. According to sexual assault prevention experts, those rapists are very likely to go on to commit crimes against other students on campus.

The U.S. Department of Justice has found that about one in four women experience sexual assault during their time in college. And, according to David Lisak — a former clinical psychologist who now consults the U.S. military and college administrations on issues of sexual assault — those sexual crimes are perpetrated by a relatively small number of men. Lisak says that most college rapists are repeat offenders.

“College presidents don’t like to hear this, but these are sex offenders,” Lisak explained during a recent rape prevention event at Harvard University. “Every report should be viewed and treated as an opportunity to identify a serial rapist.”

That claim is backed up by Lisak’s research. When Lisak surveyed 1,882 college men about their nonconsensual sexual experiences, 120 participants said that they had either sexually assaulted or attempted to sexually assault a fellow student. Those men admitted to 483 assaults in total — which averages out to be about four assaults each.

But colleges across the country still aren’t doing a good job of identifying and punishing those serial rapists. Survivors of sexual assault often have to navigate a complicated judicial system that dissuades them from reporting their assailants, suggests they may be at fault for the crimes perpetrated against them, and sometimes even threatens to punish them for speaking out. An investigation by the Center for Public Integrity found that even when students are found to be guilty of sexual assault, they tend to face extremely light punishment — like social probation and academic penalties — instead of being suspended or expelled. A recent national survey conducted by the group Students Active For Ending Rape asked college students to grade their school’s sexual assault policies, and half of the respondents gave them a C or lower. A mere 9.8 percent of students gave their university an A for handling rape cases well.

Students at prestigious universities like Swarthmore, Yale, Amherst, and Princeton allege their campuses are creating a “hostile environment” by failing to adequately address sexual assault cases — largely because administrators would rather “keep up appearances” than bring negative attention to their school by making national headlines for arresting rapists. That reality has sparked a national movement to push administrators to do better in this area, as students have filed a wave of federal complaints with the U.S. Department of Education.

Employers will struggle to comply with the new health care mandates, drop insurance coverage, increase costs, and lay off workers! Low-income employees will be subject to sky high premiums, a health care mandate they can’t afford, or go uninsured altogether!

Those are just some of the wild-eyed claims buzzing around the Affordable Care Act and its implementation. Consider this lede from Friday’s Associated Press: “It’s called the Affordable Care Act, but President Barack Obama’s health care law may turn out to be unaffordable for many low-wage workers, including employees at big chain restaurants, retail stores and hotels.” The article argues that several “wrinkles” in the law could hurt the very Americans it intended to help:

Because of a wrinkle in the law, companies can meet their legal obligations by offering policies that would be too expensive for many low-wage workers. For the employee, it’s like a mirage — attractive but out of reach.

The company can get off the hook, say corporate consultants and policy experts, but the employee could still face a federal requirement to get health insurance.

Many are expected to remain uninsured, possibly risking fines. That’s due to another provision: the law says workers with an offer of “affordable” workplace coverage aren’t entitled to new tax credits for private insurance, which could be a better deal for those on the lower rungs of the middle class.

Some supporters of the law are disappointed. It smacks of today’s Catch-22 insurance rules.

Sounds troubling.

But skip down to the end of the piece and you’ll find a curious quote from Neil Trautwein of the National Retail Federation, which represents the very employers the AP claims are going to take advantage of the health law’s impurities to increase health care costs for low-income workers while avoiding its penalties.

He appears to disagree entirely with the AP’s premise, telling the wire service that there is no “grand scheme to avoid responsibility.” ThinkProgress spoke with Trautwein, who stressed that “it is manifestly not in [employers'] interest to try to choose a benefit level that is beyond their employees’ means. No good comes of it.”

“There is the opportunity, and I’d argue the incentive, for employers to make sure that more of their employees can afford the coverage they offer,” he added, pointing to a provision of the law that requires large employers that don’t provide adequate insurance coverage (the policy has to cover at least 60 percent of health care costs) to pay a fee of $2,000 per employee after the first thirty workers. Businesses would also be assessed a penalty if they offer unaffordable coverage that forces employees to spend more than 9.5 percent of income on insurance. In that case, the employee can apply for government subsidized coverage in the exchanges and the employer pays another fine.

These penalties are designed to encourage employers to provide relatively affordable coverage and each company will have to strike the right balance of cost and benefit. But the AP, citing “corporate consultants and policy experts,” argues that businesses will find a sweet spot in offering workers expensive insurance that does not cross the affordability threshold and qualifies employees for premium assistance.
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Tobacco advertisements may spark teenagers’ desire to smoke, according to the results from a new study. In fact, for every 10 tobacco ads that teens see, researchers estimate that their risk of starting to smoke increases by nearly 40 percent and their risk of becoming a regular smoker increases by 30 percent.

German researchers examined more than 1,300 nonsmokers between the ages of 10 to 15, monitoring their exposure to tobacco advertisements in conjunction with their smoking behavior for 30 months. At the end of the 30 months, a third of the participants had tried smoking cigarettes. And the teens who had seen the most tobacco ads — between 11 to 55 — were about twice as likely to become regular smokers compared to the participants who saw the fewest ads during the 30 month period.

The World Health Organization has advocated a total ban on tobacco advertisements, pointing out that research has demonstrated eliminating this type of marketing helps decrease the demand for tobacco products. According to researchers from the Institute for Therapy and Health Research in Kiel, the new study’s findings bolster the WHO’s position. “Data from this study support this measure, because only exposure to tobacco advertisements predicted smoking initiation, which cannot be attributed to a general receptiveness to marketing,” they wrote in a journal news release.

In the 1950s and 60s, Big Tobacco companies in the United States used aggressive advertising tactics on billboards, magazine covers, television, and radio to get increasing numbers of Americans hooked on cigarettes. Last year, a federal court ruled that tobacco companies “deliberately deceived the Americans public” about the dangers of smoking in their marketing materials during that time period. Now, it’s illegal to advertise tobacco products — although some products, like e-cigarettes, are able to exploit a loophole in that regulation — and teens smoking rates have dropped to a record low. But that’s not the case in every country. WHO estimates that only 6 percent of the total global population was “fully protected from exposure to the tobacco industry advertising, promotion and sponsorship tactics” in 2010.

Here in the U.S., other big corporations have adopted some of Big Tobacco’s old marketing tactics to advertise their products to kids. Public health advocates warn that the food and beverage corporations who push their unhealthy products on youth are the next bad actors that will need additional regulation. But big companies typically rely on a “personal responsibility” argument to make the case that it’s consumers’ job to make their own decisions about whether to buy an unhealthy product.

Myriad Genetics, the biotech company whose patents on naturally-occurring human genes were invalidated on Thursday by the Supreme Court, saw its public stock tumble as competitors announced that they would be offering cheaper alternatives to Myriad’s BRCAnalysis cancer test.

While Myriad’s stock initially rose as investors took comfort in the Supreme Court’s concurrent ruling that companies could still patent synthetic or man-made DNA, it quickly fell back down to earth as competitors announced their intentions to make cheaper cancer tests:

Women who have mutations on the BRCA1 and BRCA2 genes are at significantly higher lifetime risk for developing breast and ovarian cancers. Since Myriad had a patent on those genes for the last 17 years, the company held a complete monopoly on the genetic testing market for the cancers. Myriad’s so-called BRCAnalysis runs anywhere from $500 for the simplest gene analysis to $4000 for the most extensive ones.

Those prices prove prohibitively expensive for many women, since there are significant insurance coverage gaps for genetic testing. But the Supreme Court’s decision allows companies other than Myriad to enter the marketplace and lower prices — and just hours after the ruling, several had already announced their intention to do so.

Modern Healthcare reports that Ambry Genetics blasted out an email to genetic counselors across the United States in which they promised a far cheaper BRCA test. The company says that its most expensive and detailed BRCA analysis will only cost $2200 — about half of what Myriad charges.

Other biotech firms such as Quest Diagnostics and GeneDx also said they would be getting into the cancer testing business as a consequence of the Supreme Court’s decision. While those companies haven’t announced their rates, industry observers expect prices to be lower than Myriad’s BRCAnalysis.

“For genetic counselors, the thought of patenting some type of human molecule just goes against common sense to us … We saw the effects on patients, where the costs of most genetic tests have fallen in recent years, but this test increased in cost,” said Rebecca Nagy, president of the National Society of Genetic Counselors, in an interview with Modern Healthcare.

Across the country, states’ legislative sessions are drawing to a close. Over the past several months, lawmakers have been busy enacting over 300 provisions to restrict reproductive freedom — but in some states, they’re not done yet. Even though state legislators are running out of time in the 2013 session, the following states are fast-tracking anti-abortion measures they hope to push through before adjourning:

1. WISCONSIN: Abortion opponents in Wisconsin have successfully pushed through SB 206, a measure introduced at the beginning of June, in a matter of weeks. SB 206 would require women to undergo a potentially invasive ultrasound procedure and force one of the state’s last abortion clinics to close its doors. Women’s health advocates have accused the state legislature of rushing through the bill too quickly so its opponents won’t have enough time to mobilize against it. On Wednesday, in the midst of a contentious debate over SB 206 on the Senate floor, Republicans cut off the debate and forced a vote on the legislation — even among Democratic lawmakers’ protests that the discussion wasn’t over. It passed, and now heads to Gov. Scott Walker (R), who has already promised to sign it.

2. TEXAS: The legislative session in the Lone Star state has already ended, but that doesn’t mean Texas women are safe from assaults on their reproductive rights. Gov. Rick Perry (R) has called a special session to give lawmakers a chance to consider legislation that hasn’t been able to advance yet, after anti-choice lawmakers pressured him to give them a chance to keep trying to push through abortion restrictions. This year, Democrats successfully blocked at least 24 anti-abortion bills introduced during the regular session. But they may not be able to do so in the current special session, which is operating under different rules that allow for less debate. Now, Republican lawmakers may be able to successfully advance SB 5, a sweeping anti-choice measure that would criminalize abortions after 20 weeks of pregnancy, shut down 80 percent of the state’s abortion clinics, and limit women’s access to the abortion pill.

3. OHIO: Lawmakers in Ohio are currently engaged in budget negotiations — and abortion opponents have attached amendments to the proposed budget that would defund Planned Parenthood, shut down abortion clinics, and redirect state funding to right-wing “crisis pregnancy centers” that mislead women about their reproductive options. Earlier this week, a coalition of Ohio Republicans also introduced a separate abortion bill that combines several egregious attacks on women’s health into one measure. HB 200 would — among other things — mandate invasive ultrasounds and require women to cover the additional cost of the procedure, force women to wait 48 hours before accessing abortion services, and require doctors to tell their patients about a widely debunked link between abortion and breast cancer.

4. NORTH CAROLINA: At the end of May, the North Carolina legislature approved new abortion restrictions — including a measure preventing women from using their own insurance plans to cover abortion care — right before a deadline that non-budget bills must meet in order to stay alive in the next session. But even though the legislative focus has now turned to the state budget, that hasn’t stopped Republicans from continuing to push anti-abortion measures. Lawmakers have tacked on a budget amendment to allocate health care funds to crisis pregnancy centers, despite the fact that they don’t actually offer the full range of women’s health services, like contraception or abortion referrals. The new budget priorities, which also include tax breaks for the wealthy and cuts for other social service programs, have sparked mass protests at the state capitol building this week.

Ireland’s prime minister says he has received letters from anti-abortion activists calling him a “murderer” as his administration considers including an extremely narrow exception to the country’s total abortion ban. Enda Kenny says that some of the letters have been written in blood.

“I am now being branded by personnel around the country as being a murderer, that I am going to have on my soul the death of 20 million babies,” Kenny said on Wednesday, explaining that he has also received threatening messages. “I’m getting medals, scapulars, plastic fetuses, letters written in blood, telephone calls all over the system, and it’s not confined to me.”

Spurred by the international outrage surrounding the death of Savita Halpannavar — an Indian woman who died after being denied an emergency abortion in an Irish Catholic hospital — Kenny approved legislation in April that would allow women to access abortion services if their life is in danger. On Wednesday, Ireland’s ministers signed off on a completed form of the legislation, and the parliament hopes to enact it before adjourning in July.

But, even though Ireland’s amended abortion law is still incredibly harsh — it doesn’t include any exceptions for rape, incest, or fatal fetal defects, and women’s health advocates caution that it’s only an incredibly small step toward greater reproductive rights — the deeply conservative nation has erupted into controversy. Abortion opponents in Ireland claim that any exceptions whatsoever to the nation’s total abortion ban will pave the way for future legalization efforts. Ireland’s Catholic bishops have urged the government to block the legislation, arguing that allowing dying women to access reproductive care is “not necessary to protect women.”

But the country’s powerful Catholic leaders stand in sharp contrast to public opinion. A recent poll published in the Irish Times found that 89 percent of the population wants legal abortion services to be available in cases where a woman’s life is in danger. And the Irish people favor greater reproductive access than the current legislation provides. Eighty three percent support legal abortion in cases when the fetus won’t be able to survive at birth, 81 percent support legal abortion access for victims of rape and incest, and 78 percent support legal abortion to protect a woman’s health (not just her life).

The Guttmacher Institute has found that restrictive laws banning abortion don’t actually lower abortion rates. Women who need to terminate a pregnancy will find a way to do it regardless of the law, but they may end up risking their health to do so. Women’s health activists in Ireland help educate women about how to travel to other countries in Europe and obtain abortions there, but they could face up to 14 years in prison if they’re caught.

According to the American Civil Liberties Union (ACLU), the 2013 legislative session is on track to be yet another record-breaking year for state-level restrictions on women’s reproductive rights. As states’ current legislative sessions begin to come to a close, lawmakers have so far introduced more than 300 different abortion restrictions this year, as detailed in a map from the ACLU (click through for the interactive version):

According to the Guttmacher Institute, 2011 saw the highest number of anti-abortion restrictions enacted on the state level since 1985, when the women’s health organization first began tracking the data. 2012 was right behind with the second highest number of restrictive abortion laws. And now, even following an presidential election season that heavily emphasized the ongoing War on Women — post-election polling suggests that Mitt Romney’s right-wing positions on women’s health issues may have cost him the White House — local lawmakers in red states are continuing to pursue a stringently anti-abortion agenda.

On a call with reporters, representatives from the ACLU’s Reproductive Freedom project pointed out that abortion opponents have been more aggressive about their goals in 2013, and predicted this year will “go down in record books” for advancing some of the most stringent legislation this nation has seen since Roe v. Wade legalized abortion 40 years ago. The ACLU considers the mounting pile of state-level restrictions to be a “coordinated campaign” to eventually ban abortion in every clinic in every state. The group points out that there are three prongs of attack in this national strategy: making abortion services inaccessible for women, making it impossible for abortion doctors to continue their work, and forcing abortion clinics to close their doors.

Since the first part of that three-tiered strategy often involves outright bans on abortion, like the unprecedented 6-week ban in North Dakota and 12-week ban in Arkansas, it tends to incite the most outrage and receive the most media coverage. But the second and third tactics employed by the right wing are also incredibly successful at limiting women’s reproductive options — and, since those laws can more easily fly under the radar, they can actually be more dangerous.

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Republican pushed a bill to criminalize abortions after 20 weeks through the House Judiciary Committee on Wednesday, sending the measure on to the full House. But not all members of the majority are cheering the move.

Rep. Charlie Dent (R-PA) told CQ Roll Call that the plan to rush the bill through next week is a stunning distraction from more important issues.

“I’ll be very frank: I discouraged our leadership from bringing this to a vote on the floor,” he observed. “Clearly the economy is on everyone’s minds, we’re seeing very stagnant job numbers, confidence in the institution of government is eroding and now we’re going to have a debate on rape and abortion… The stupidity is simply staggering.”

The bill’s sponsor, Rep. Trent Franks (R-AZ), made headlines after claiming during the Judiciary Committee debate that “the incidence of rape resulting in pregnancy are very low.”

The legislation, which is strongly endorsed by the National Right to Life Committee, would criminalize abortion services after 20 weeks of pregnancy. That cut-off is based on the scientifically-disputed idea that fetuses begin to feel pain around 20 weeks — even though women have a constitutional right to abortion services until the point of viability, generally understood to occur around 24 weeks of pregnancy, under Roe v. Wade.

Banning late-term abortion services is a popular anti-choice tactic to chip away at reproductive choice and narrow the window during which women can access legal abortion services. But 20-week bans have been met with legal challenges. Just last month, an appeals court struck down a 20-week abortion ban in Arizona, and similar measures have been blocked in Idaho and Georgia.

The bill is likely to pass the House, since anti-abortion Republicans hold the majority, but is considered doomed in the Democratic-controlled U.S. Senate.

California teacher Carie Charlesworth was fired for the “crime” of being a victim of domestic violence, according to letters obtained by NBC San Diego.

The firing was prompted by Charlesworth’s abusive ex-husband Martin Charlesworth, who invaded the Holy Trinity School parking lot after a weekend where Carie had called the police on him three times, sending the school into lockdown.

Martin was sent to prison, but Carie herself was also punished. On April 11th, the school sent a letter to her informing her of her dismissal. The grounds? Her husband was dangerous:

We know from the most recent incident involving you and Mrs. Wright (the principal) while you were still physically at Holy Trinity School, that the temporary restraining order in effect were not a deterrent to him. Although we understand he is current incarcerated, we have no way of knowing how long or short a time he will actually serve and we understand from court files that he may be released as early as next fall. In the interest of the safety of the students, faculty and parents at Holy Trinity School, we simply cannot allow you to return to work there, or, unfortunately, at any other school in the Diocese.

Charlesworth cited the decision as an example of the pervasive stigma domestic violence victims face on top of the abuse itself. “That’s why women of domestic violence don’t come forward,” she told NBC. “They’re afraid of the way people are going to see them, view them, perceive them, treat them.”

Though a recent federal study of gendered violence found that over a third of American women experience intimate partner violence over the course of their lives, the fear Charlesworth describes deters reporting of these crimes with depressing frequency. According to one survey of the relevant data, “because of the stigma associated with intimate partner violence, the fact that it is an illegal activity, and the very real fear of potential retribution from a violent partner, respondents perpetrating or being victimized are less likely to answer questions about intimate partner violence than those who are not.” What goes for answering survey questions goes double for reporting a crime.

Victims can even face legal consequences for calling the police. If a victim generates enough nuisance citations (as defined by the local nuisance ordinance), calling in the ostensibly-protective authorities will often lead to the victim’s eviction. A study of one such ordinance in Milwaukee found that roughly a third of nuisance citations were responses to domestic violence incidents, and the most common landlord remedy was to evict the battered woman.

Charlesworth is planning to challenge her dismissal in court, but the school appears to have the upper legal hand as a consequence of a broadly worded religious exemption.

Faced with enormous political pressure from Gov. Jan Brewer (R-AZ), the Arizona House passed a budget and Obamacare’s Medicaid expansion in a rare 3:40 a.m. vote on Thursday. The bills now go back to the state Senate — where they are expected to pass easily later this morning — for final approval before heading to Brewer’s desk for her signature.

The vote signifies the final skirmish in a five-month long battle to expand Medicaid that pit the combative Brewer against members of her own party and conservative constituents. The window for passing the expansion and a budget would have closed on July 1st. With that deadline looming, Brewer called a surprise, special legislative session on Tuesday without getting permission from — or even informing — lawmakers in her party.

Studies by the Kaiser Family Foundation (KFF) have shown that expanding Medicaid will cut Arizona’s uninsurance rate by nearly third. That means approximately 50,000 low-income Arizonans will be covered for medical benefits such as doctor’s visits, prescription drugs for chronic conditions like diabetes, and mental health care services.

Brewer made expanding Arizona’s Medicaid program under the health law a top priority for this legislative session. After becoming the third GOP governor to endorse expansion in January, she held rallies throughout the state meant to shore up support for the controversial Obamacare measure, and implored Republican moderates to vote for it. Brewer often used personal rhetoric that emphasized the consequences failing to expand Medicaid would have on Arizona’s poor. “The human cost of this tragedy can’t be calculated,” she said during a rally in March.

Thursday’s victory came only after significant tensions threatened to derail the entire process. Brewer played political hardball to push the expansion, even following through on a threat to shut down lawmaking entirely until she had a budget and the Medicaid expansion bill on her desk. She refused to compromise with Republican House Speaker Andy Tobin, who had proposed a far more conservative alternative plan that would have put a time limit on how long poor Arizona residents could qualify for the expanded program.

The tough tactics earned her scathing reviews from conservatives, with the chairman of the Maricopa County Republican Committee calling her a “rogue governor.” Republican lawmakers who opposed the expansion also slammed Brewer for her aggressive methods in speeches on the House floor Thursday.

Arizona will now be the 21st state to expand Medicaid under Obamacare.

Ohio Republicans are already attempting to hijack the state’s budget process to push for abortion restrictions, advancing a version of Gov. John Kasich’s budget bill that includes amendments to defund Planned Parenthood and shut down abortion clinics. But they’re not stopping there. Now, a group of 35 Republican lawmakers in the House have introduced an omnibus anti-abortion bill that combines some of the worst attacks on women’s reproductive health into a single measure.

House Bill 200, introduced by state Rep. Ron Hood (R) and backed by 34 of his fellow Republicans, includes the following restrictions on the women who seek abortion care and the doctors who provide it to them:

Mandates invasive ultrasounds, and forces women to pay for the cost of the extra procedure themselves.

HB 200 would require women seeking abortions to undergo a mandatory ultrasound, a medically unnecessary procedure that is otherwise left to the discretion of a woman and her doctor. Although the bill does not specify which type of ultrasound procedure would be required — either an invasive transvaginal probe, or a less-invasive abdominal scan — it does note that it it must portray “the entire body of the embryo or fetus.” That will likely require many women seeking early abortion care in their first trimester to undergo a transvaginal ultrasound, since that’s the only effective method of providing a clear image during the first 12 weeks of pregnancy. Under HB 200, women would be required to pay out-of-pocket for the ultrasound procedure — an additional medical cost on top of the high cost of abortion services.

Requires doctors to describe the ultrasound images to women seeking abortions, including details about the fetal heartbeat.

On top of forcing women to pay for an ultrasound that they may not consent to, HB 200 stipulates that doctors must provide details about the ultrasound images to their patients. If there’s an audible fetal heartbeat, doctors will need to describe it. Planned Parenthood argues these type of requirements simply serve to distress emotionally vulnerable women, and attempt to make them feel ashamed about their choice to end a pregnancy. “Information about a woman’s pregnancy should support a woman,” Celeste Glasgow Ribbins, a spokeswoman for Planned Parenthood of Greater Ohio, pointed out. “This information should not be provided with the intent of shaming her or coercing her.”

Extends the waiting period for abortion to 48 hours, and eliminates the option for women to bypass it because of a medical emergency.

Ohio already forces women to wait 24 hours before having an abortion, an unnecessary restriction that ultimately requires women to make multiple trips to a clinic and can end up imposing serious financial burdens on women seeking abortions. HB 200 would extend that waiting period to 48 hours. And the proposed legislation would eliminate the “medical necessity” exemption that currently allows women to bypass the waiting period if they require immediate care. Under HB 200, even if a woman is experiencing a serious medical issue and needs to terminate a pregnancy immediately, she will still be forced to wait two days.

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As a growing number of Americans are turning away from smoking, the nation’s largest tobacco companies are ramping up production of high-tech cigarettes that could lead an entirely new generation of Americans to become addicted smokers — and the government is doing nothing to stop them.

Next month, R.J. Reynolds, the second-largest tobacco manufacturer and maker of Camel, Salem and Winston, will start selling Vuse — an electronic cigarette the size of a slick, thin pen. The product is packaged like the latest release from Apple, surrounded by clear plastic and a crisp logo, set against a clean black background. It even comes with a USB charger. When a user inhales, a sensor heats the liquid nicotine solution, emitting an odorless vapor.

“It’s a high-tech product, there are in fact micro chips inside the cartridges that communicates with the processor inside the power unit, so it’s a sophisticated piece of technology,” spokesperson Richard Smith said. “The package design is to compliment the technical forward facing digital nature of this product, same with the design of the product itself.” July’s campaign is “just the first of a major national roll out” that will include the full range of marketing support and advertising, including T.V. commercials.

Electronic cigarettes or e-cigarettes have been on the market for several years, raking in just a fraction of the tobacco market, $500 million in 2012. But the recent decision by all three big tobacco companies to develop e-cigarette lines has analysts anticipating up to $1 billion in sales this year, with the possibility that the next generation of smokes could even “surpass consumption of traditional cigarettes in the next decade.” Altria Group, the owner of Philip Morris USA — the largest tobacco company in the country with brands like Marlboro, Virginia Slims, and Parliament — unveiled a new e-cigarette on Tuesday. And Lorillard, the third largest manufacturer of cigarettes in the United States, with brands like Newport and Kent, acquired the e-cigarette company blu in April 2012.

“E-cigarettes are to tobacco what energy drinks were or are to beverages,” Bonnie Herzog, an analyst at Wells Fargo Securities who follows the tobacco industry, told the New York Times last year. “It is a small category that is growing very fast, embraced by retailers and consumers.” Indeed, in 2011, the Centers for Disease Control and Prevention found that “more than 20 percent of adult smokers said they had tried e-cigarettes, double the rate in 2010.”

Phillip Morris and R.J. Reynolds pushed back against claims by health groups that e-cigarettes are designed to appeal to young nonsmokers, insisting that their products are for “consumers looking for alternatives to traditional cigarettes” and are not meant to target those who have quit or haven’t started. “It’s a guiding principle of Reynolds operating companies, including JRVapor, that adults who do not smoke should not start and those who quit should not re-start,” Smith said. “Kids should never have access to tobacco products.”

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Over the past year, a growing number of prestigious colleges have made national headlines over their administrations’ failure to effectively handle issues of sexual assault on campus. That’s not necessarily because rape culture on college campuses has recently gotten much worse than it used to be. More likely, it’s because a coordinated network of students activists are joining forces to fight for real change, perhaps partially spurred by the national conversation about sexual assault that followed the high-profile Steubenville rape case.

Much of that movement was sparked by one activist in particular: Andrea Pino, who filled a federal complaint against the University of North Carolina after feeling “let down by the people and policies that were supposed to protect her” when she was raped at an off-campus party.

But Pino knew the deeper issues of victim-blaming and rape culture were bigger that her university, and she didn’t want to stop at reforming UNC’s sexual assault policy. After she and some of her classmates took action against UNC, they joined forces with students on other campuses to help them file their own complaints. Pino and her classmate, Annie Clark, became somewhat of informal advisers for other college activists across the country who were interested in pushing back on their own administrations.

The UNC student explained that the real change started occurring once students began to connect the dots between campuses. “It was always an individual case. That’s what kept this from becoming a movement,” Pino told Inside Higher Ed. Before forming a network, it was easy for students to think about every on-campus rape, or every violation of university sexual assault policy, as an isolated incident. And many students didn’t feel comfortable coming forward with their stories because they assumed they wouldn’t have any support from their peers, and they would be accused of lying — one of the most common consequences of universities’ pervasive victim-blaming atmospheres.

But after campus activists joined together, they started gaining strength in numbers. Insider Higher Ed describes the recent momentum around sexual assault policy as “an unprecedented wave of student activism and federal complaints at campuses.”

And that increased activism has paid off. Thanks to the continued pressure that students are putting on their administrators, colleges are beginning to take small steps to reform their sexual assault policies. Some universities are agreeing to incorporate more resources about sexual health, domestic violence prevention, and consent into their campus communities. Others have formed task forces to overhaul their current judicial policies for handling rape cases among students.

Members of the higher education community suspect this is just the beginning, and anticipate another round of formal complaints as even more students get connected with the movement and become aware of their rights under federal law. “I think all of the attention that has been brought to this subject over the last two years has created much more awareness, and perhaps emboldened students who otherwise would have felt more isolated in coming forward,” Ada Meloy, the general counsel of the American Council on Education, explained. “I think there’s no question that this topic is one that is not going away.”