Arizona Gov. Jan Brewer, a vocal opponent of President Obama’s health reform law, surprised her Republican colleagues when she announced her support for Obamacare’s Medicaid expansion at the beginning of this year. Since then, Brewer has been attempting to broker a deal with the legislators in her state, who will ultimately need to approve the legislation to expand the public health insurance program.

And as negotiations over Arizona’s Medicaid expansion plan go back and forth, some of the state’s powerful lobbyists are attempting to attach amendments to the proposal to suit their own interests — including a totally unrelated attack on Planned Parenthood, which has become a symbol in the GOP’s ongoing crusade against women’s health.

Obamacare proponents warn that additional amendments could threaten to derail the whole expansion process altogether, since Democratic lawmakers may not be willing to pass a bill with unrelated riders. Nonetheless, one of the state’s most powerful lobbying groups is jumping on the opportunity to target Planned Parenthood, regardless of the potential consequences for Arizona’s low-income residents who may be forced to go without health care if the expansion doesn’t go through:

The Center for Arizona Policy is using an opinion from the Arizona-based Alliance Defending Freedom, a Christian legal-defense organization, to argue that the draft Medicaid legislation should be amended to disqualify the non-profit women’s health provider Planned Parenthood from receiving public money. [...]

[Cathi Herrod, the center’s president] said her organization, a conservative Christian-based group that wields influence with GOP lawmakers, is not taking a position on Medicaid expansion and wouldn’t comment on the possibility that such an amendment could sink the plan.

“Our request is to include language guaranteeing that no funding to an abortion provider results from Medicaid expansion,” Herrod said. “Any dollar that goes to an abortion provider for any service frees up another dollar to subsidize abortion.”

Planned Parenthood gets a fraction of its funding from Medicaid but could pick up more patients if the state broadens eligibility. Although Herrod argues that funding to the clinics indirectly supports abortion, Planned Parenthood officials say they lose money on every Medicaid patient because of reimbursement levels.

The proposed amendment to Arizona’s Medicaid expansion is very similar to a measure that Brewer signed into law last year, which also sought to prevent federal Medicaid dollars from going to Planned Parenthood. Last month, a federal judge blocked that law from taking effect — since state-level Medicaid programs cannot exclude qualified providers from providing essential heath care to the low-income Americans who need it, Arizona is not permitted to target Planned Parenthood simply because the national organization performs abortions.

But even Arizona’s failed record won’t deter the abortion opponents in the state from continuing to go after Planned Parenthood. Bryan Howard, the president of Planned Parenthood Arizona, sharply criticized the Center for Arizona Policy and Herrod for pursuing a “failed legislative strategy” that could jeopardize the state’s Medicaid expansion. “She has to know that she is putting health-care access for 400,000 people at risk,” Howard told the Arizona Republic.

The North Dakota legislature recently passed the harshest abortion ban in the nation, and is also considering two “personhood” measures that would outlaw abortion altogether. But state lawmakers also want to target abortion by going after Planned Parenthood — even when it comes to the organization’s preventative sexual health resources for youth. Republicans are now attempting to block a comprehensive sex ed program that North Dakota State University (NDSU) was planning to launch in partnership with Planned Parenthood.

NDSU won a three-year federal grant to partner with Planned Parenthood to provide sexual education resources to at-risk youth. The voluntary sex ed program is designed to offer family planning resources and life coaching for teenagers at high risk for unintended pregnancy, and would take place outside of school hours. However, the grant was frozen earlier this year after abortion opponents attempted to derail the initiative because Planned Parenthood was participating — even though the state’s affiliates don’t perform any abortion services. North Dakota’s Attorney General gave NDSU permission to proceed with the sex ed program last month. Unfortunately, the fight over sex ed isn’t over yet.

Now, state legislators are joining the crusade against Planned Parenthood. On Monday, the House Human Services Committee approved an amendment to a Senate bill that would prohibit the use of government funds to “contract with, or provide financial or other support to individuals, organizations, or entities performing, inducing, referring for, or counseling in favor of, abortions.” The amendment notes that this ban would apply to any “institution under the control of the State Board of Higher Education” — and would sure that NDSU’s sex ed grant won’t move forward with Planned Parenthood’s participation.

The president of the Planned Parenthood affiliate for Minnesota, North Dakota, and South Dakota points out that blocking comprehensive sex ed resources actually undermines anti-choice politicians’ goal of preventing abortions. “Politicians in North Dakota who are opposed to abortion are blindly taking aim at the very agencies that can prevent them,” she explained in a statement. “If you want to reduce the number of abortions, the last thing you should do is take away programs that help young people prevent pregnancy before they are ready to have a family.”
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At the beginning of this year, Texas officials succeeded in their yearlong crusade to defund Planned Parenthood, a move that has forced thousands of low-income women to search for new doctors — and Republicans in the state show no signs of easing up in their obsession to block the national health organization at every turn. But, in a state where half of all pregnancies were unintended in 2011, Texas’ vendetta against Planned Parenthood has had stark consequences.

As Mother Jones details, the attacks on women’s health in the Lonestar State have made a serious, quantifiable impact. Now that Texas Republicans have left significantly fewer resources to provide low-income or uninsured women with the programs they need, this is what’s happening, by the numbers:

• Planned Parenthood provided care for nearly 50 percent of the low-income women who get Medicaid benefits through Texas’ Women’s Health Program (WHP) before anti-choice lawmakers kicked the organization out of the program.
• Thanks to the decline in state funds designated for family planning services, Texas is now funding 176 fewer health clinics than it did in 2011.
• 53 health clinics in Texas have been forced to close as a result of the budget cuts. 39 of those weren’t affiliated whatsoever with Planned Parenthood, and zero of them performed abortions.
• After health clinics began closing their doors last year, a survey of about 300 Texas women seeking abortions revealed that nearly half of those women were “unable to access the birth control that they wanted to use” in the 3 months before they became pregnant. Women cited cost barriers, lack of insurance coverage, and inability to find a clinic.
• Now that lawmakers have both cut family planning programs and defunded Planned Parenthood, 200,000 low-income women in Texas have already lost or could soon lose access to birth control, cancer screenings, and other critical preventative care.
• Because so many women are losing access to the preventative resources they need, the family planning cuts are projected to result in an additional 24,000 unplanned births between 2014 and 2015.
• Every dollar invested in family planning services leads to as much as $5.60 in Medicaid savings. On the other end of the spectrum, the increased unplanned births resulting from Texas’ cuts are expected to cost taxpayers an estimated additional $273 million in medical expenses and Medicaid coverage.

(HT: Mother Jones)

State Sen. Jason Rapert (R-AR) is the architect of the nation’s most stringent abortion legislation — Arkansas’ “fetal heartbeat” ban outlawing all abortion services after just 12 weeks, which could take effect as early as this spring. But Rapert isn’t content with potentially banning one out every 10 abortions in his state. Now, he’s looking to continue his attacks on women’s health by cutting off funding to Arkansas-area Planned Parenthood clinics.

So far this year, Arkansas Republicans have already pushed through several stringent abortion restrictions — a 20-week “fetal pain” ban, the record-breaking 12-week ban, and a measure to prevent insurance coverage of abortion services — but they have even more waiting in the wings. Now, Rapert wants to target Planned Parenthood with an initiative that will ultimately strip funding from preventative care and comprehensive sexual education programs:

Rapert is now calling for the state to prohibit any state or federal funds from going toward any entity that performs abortions. It’s a measure that’s aimed at cutting off public funding to Planned Parenthood, which doesn’t perform surgical abortions in Arkansas but distributes the abortion pill at two facilities in the state. Arkansas’ only clinic that performs surgical abortions is in Little Rock.

The proposal would cut off money Planned Parenthood receives from the state for non-abortion programs, including federal grants disbursed by the state to the group for education programs in Little Rock schools on sexually transmitted diseases. [...]

Planned Parenthood officials vowed to fight the legislation.

“For many Arkansas women we care for, we are the only health care provider they rely on every year for affordable care including well woman exams, lifesaving cancer screenings, contraception, and STD prevention,” said Jill June, president and CEO of Planned Parenthood of the Heartland. “Planned Parenthood will fight this dangerous bill just as we fought Senator Rapert’s abortion ban — politics should never come between a woman and her medical care.”

Arkansas Republicans have been celebrating their victories in the 2012 election, when they won both chambers of the state legislature for the first time in nearly 200 years, by obsessing over undermining women’s reproductive rights. So far, the abortion restrictions that the Arkansas GOP has enacted this session are more stringent than any other laws adopted in the state’s recent history — including during the 10 years that anti-choice Gov. Mike Huckabee (R) was in office. (It’s also worth noting that although current Gov. Mike Beebe is a Democrat, he has a mixed history on abortion rights and signed the new insurance coverage ban.)

Rapert is open about the fact that his party is moving full steam ahead with its anti-abortion agenda. “For years in the state of Arkansas, these types of bills have been filed but have never been able to see the light of day because they were killed in committee who were not pro-life,” the state lawmaker explained. “That’s why you see these bills making it today.”

Unfortunately, despite the fact that ensuring women have access to affordable reproductive services will actually help lower abortion rates, Rapert’s decision to go after Planned Parenthood is unsurprising now that abortion opponents have successfully transformed the organization into a symbol in their ongoing attack on reproductive rights. Fortunately, courts have blocked most state-level efforts to defund the national organization — but anti-Planned Parenthood crusades like Rapert’s have still eliminated some essential women’s health services in Texas, Oklahoma, Wisconsin, and Tennessee.

Texas has already spent the past year targeting Planned Parenthood, effectively defunding the organization’s affiliates and forcing thousands of women to search for new doctors. But their crusade isn’t over yet. Now, a Texas Republican also wants to prevent sex ed classes in public schools from using any of Planned Parenthood’s instructional materials, claiming that the national women’s health organization places an “inappropriate emphasis on sexual freedom.”

Sex education classes are not required in Texas. School districts that decide to provide that type of instruction must make their materials available for public review, as well as allow parents to remove their children from the course for any reason. But State Sen. Ken Paxton (R) wants to put even more restrictions on health classes by preventing “abortion affiliates” from providing any sexual health instruction or contraceptive resources.

Texans who back Paxton’s measure argue that Planned Parenthood can’t be trusted to provide sex ed because, since the organization doesn’t want to “lose abortion business,” it has a vested interest in convincing teenagers to have sex and get pregnant:

During Tuesday’s hearing on Paxton’s bill, Renate Sims of Round Rock told the Senate Education Committee she strives to teach her five children that “married sex and only married sex is appropriate.”

“Abortion providers like Planned Parenthood and their affiliates can’t possibly communicate this message effectively because of their inherent conflict of interest. If teenagers consistently viewed sex as something to be saved for marriage, Planned Parenthood would lose abortion business,” Sims said.

Although several speakers criticized the way sex education is handled in specific districts, no supporter of Paxton’s bill provided examples of Planned Parenthood materials or information that has actually been used in schools.

Planned Parenthood is an extremely qualified women’s health provider with a long history of providing sexual health instruction, although abortion opponents often undermine sex ed resources for youth with the sole goal of targeting Planned Parenthood. Even though the organization may not emphasis abstinence in its instructional materials, that’s because abstinence-only programs don’t work, and teens are better equipped to make healthy decisions when they have accurate, scientifically-based resources about their bodies.

If Texas lawmakers are actually concerned about preventing an uptick in unintended pregnancies, they might want to reexamine their own policies rather than focusing on Planned Parenthood’s instruction materials. Since GOP legislators stripped funding from family planning providers in the last budget cycle, about 280,000 low-income women will lose access to affordable birth control — which the state’s health department projects will lead to an estimated 23,760 additional births, costing taxpayers up to $273 million. And, of course, Texas’ lack of comprehensive sex ed requirements are likely directly contributing to the state’s high rates of teen pregnancy.

Republicans have made Planned Parenthood into a top target in their ongoing War on Women, repeatedly attempting to strip funding from the national women’s health organization because some of its affiliates provide abortion services. Despite the fact that the Hyde Amendment already prevents taxpayer dollars from funding abortion — which means that Planned Parenthood’s federal and state funding simply goes toward providing preventative health care for women who often aren’t able to access those services elsewhere — GOP lawmakers still aren’t convinced. They’re still eager to find a reason to defund Planned Parenthood, and they’re willing to waste time and money to search for one.

Nearly 70 Republicans have signed onto a letter asking the Government Accountability Office (GAO) to take a closer look at the way Planned Parenthood and other abortion providers use taxpayer dollars. Even though there’s already a federal law that stipulates exactly how those funds may be used, they still claim the study is “critically needed to shine a bright light on how taxpayer funds are allocated” — but the GOP proponents of the effort admit their real goal is to justify stripping funding from Planned Parenthood:

Those spearheading this effort — Rep. Diane Black (R-Tenn.), Rep. Pete Olson (R-Texas) and Sen. David Vitter (R-La.) — are hoping the study confirms their suspicions that these groups are focusing more on abortion and less on other healthcare services. Black said this finding could be used to justify a reduction in federal funds to abortion providers. [...]

Black added that Planned Parenthood showed in its latest report that they are providing more abortions, and fewer other health services, all while federal funding has increased. “An independent study of the federal funding for abortion providers is necessary to further expose the truth of how these precious taxpayer dollars are truly being used,” Black said.

House Republicans are already tripping over themselves to attempt to defund Planned Parenthood, introducing two identical bills at the beginning of the legislative session that both target the nonprofit organization. They’re unconcerned about their doubled efforts because, as Rep. Marsha Blackburn (R-TN) explained to the Huffington Post, “The fact that there are multiple members interested in this issue proves that Planned Parenthood is not going to be let off the hook.”

But that message may not be particularly well-received by the American people. Post-election polling confirmed that women’s issues, including lawmakers’ stance on whether Planned Parenthood should remain fully funded, were decisive factors in the presidential election: 64 percent of all voters said they heard something about Mitt Romney’s intent to defund Planned Parenthood, and 62 percent disagreed with that position.

That’s apparently not enough to dissuade Republicans in Congress, who have a long track record of focusing on the same pointless issues — the 112th Congress unsuccessfully attempted to repeal Obamacare over 30 times, for example — rather than tackling their long to-do list on important polices like disaster relief, job stimulation, deficit deals, and resources for sexual assault victims.

Republican lawmakers in Wisconsin have singled out Planned Parenthood in their crusade against women’s reproductive health — a popular anti-choice tactic that states like Texas, Oklahoma, and Arizona have also employed over the past year. And now that Gov. Scott Walker’s (R-WI) budget has stripped over a million dollars of funding from the women’s health organization, it will be forced to close four of its rural health clinics within the next several months.

“Closing these centers is a direct result of the budget cuts from last cycle, when the Republicans kicked Planned Parenthood out of the budget,” Nicole Safar, Planned Parenthood of Wisconsin’s public policy director, explained to RH Reality Check. And since the four clinics that will be forced to close their doors are located in rural areas, Planned Parenthood officials warn that the low-income women who used to rely on them will now be forced to travel up to an hour to visit a clinic in another county:

“They weren’t reimbursements for patient services directly,” said Nicole Safar, director of public policy for Planned Parenthood of Wisconsin. “None of these centers provided abortion services…In these communities, there is nowhere else for low-income women to get these services. These centers focused on preventing unplanned pregnancies and reducing the need for abortions.”

The centers provided 11,400 health care services a year. Officials said they worry that the closings will mean that about 2,000 people in the affected communities won’t be getting checkups or treatment, putting patients at risk of cancer and other illnesses.

“The women who come in to see me every day don’t care if their legislators are Republicans or Democrats,” said Deb Lidbury, a nurse practitioner at Planned Parenthood. “What they care about is having access to screenings, birth control and having access to someone who can answer their immediate concerns and questions. Many of the patients I see may skip their annual exam or go without getting a lump check.”

Walker’s 2011-2013 budget stripped funding from health organizations that are affiliated with abortion services, which disproportionately impacted the state’s Planned Parenthood clinics. State and federal laws already prohibit federal funds from going toward abortion — so none of the organization’s locations were using that money to fund abortion services in the first place.

Unfortunately, attacks on Planned Parenthood clinics are hardly the only anti-choice policies that Wisconsin women have to worry about. The top Republican lawmakers in the state confirmed last week that mandating an invasive transvaginal ultrasound for women seeking abortion is a “priority” for them. And new restrictions on medication-induced abortions are already forcing women’s health clinics in Wisconsin to stop offering medicine abortion services for the women who want to terminate a pregnancy during the first trimester.

In a blow to anti-abortion activists looking to use Planned Parenthood as a political pawn in their crusade against women’s reproductive health rights, a federal judge has overturned an Arizona law signed by Gov. Jan Brewer (R) in May 2012 that prohibits using Medicaid funds for services provided by Planned Parenthood facilities in the state.

Judge Neil Wake ruled that Arizona residents “are entitled to get their services from any qualified medical provider,” and the fact that Planned Parenthood provides some abortion-related services does not disqualify the organization from being a “qualified provider,” as the law claimed it did.

State and federal GOP officials have been tripping over each other to strip Planned Parenthood of its federal funding — even though federal dollars can’t be used to cover abortion services, through Planned Parenthood or any other medical provider. Planned Parenthood is actually simply a health care provider for low-income women in the Medicaid program, providing them with preventative screenings and family planning services.

Republican efforts to defund Planned Parenthood have already taken a toll on low-income women in states like Texas, where the war against the provider has sharply curtailed the number of doctors and services available to women, and Oklahoma, where women’s health clinics have been forced to close. But federal courts have consistently ruled that efforts to cut off Medicaid funding to Planned Parenthood is an overreach, stripping low-income women of essential medical resources.

Wake’s injunction against the Arizona law has already been appealed.

Women’s health is under attack all across the country — in fact, at this point, every single state except for Oregon has enacted at least one abortion restriction to limit access to reproductive services. But some states seem to be competing for the dubious title of the very worst state for women. Right now, North Dakota is pulling into the lead.

North Dakota Republicans have wasted no time so far this year attempting to roll back women’s reproductive rights. Just barely over a month into 2013, North Dakota’s lawmakers are already pushing at least five serious attacks on women’s health:

1. Threatening to close the state’s last abortion clinic. On Thursday, state senators advanced legislation that threatens to close down North Dakota’s only remaining abortion clinic, the Red River Women’s Clinic in Fargo. The legislation would require all doctors who perform abortion services to have hospital-admitting privileges — a complicated and unnecessary step that will likely prevent abortion doctors from continuing to practice in the state. It’s incredibly similar to the GOP-led effort in Mississippi, another state that has just one abortion clinic left, where abortion doctors have been unable to gain hospital privileges and women may soon be left without many options for their reproductive care.

2. Advanced a “personhood” amendment. Republican senators also advanced a personhood measure on Thursday that would amend the state’s constitution to endow zygotes with the full rights of U.S. citizens. If the measure passes, fetuses would be granted all of the legal rights and protections of North Dakota residents — which would ultimately ban abortion, some forms of contraception, and even invitro fertilization. Personhood initiatives are so radical that they haven’t seen much success even within the anti-abortion community.

3. Considering a “fetal heartbeat” bill. Just to hedge their bets in case the extreme personhood amendment doesn’t work out, North Dakota lawmakers are also considering the next best thing: a “heartbeat” ban to outlaw abortion as soon as a fetal heartbeat can be detected, which can occur as early as six weeks of pregnancy. At that point, some women don’t even know they’re pregnant yet — but North Dakota’s heartbeat ban would criminally prosecute them for having an abortion by the time they figured it out.

4. Could mandate transvaginal ultrasounds. The other conservative states that are beginning to propose “heartbeat” bills are quickly learning that this type of legislation may be even more hostile to women’s rights than they first imagined. Because the measures would require doctors to check for a fetal heartbeat before proceeding with an abortion, they would necessitate a transvaginal ultrasound — an unnecessary, invasive procedure — since that’s the only way to detect a fetal heartbeat so early in the pregnancy. The sponsor of Arkansas’ heartbeat bill has amended his legislation to specify that it wouldn’t ban abortion until the fetal heartbeat can be detected with an abdominal ultrasound, but North Dakota’s Republicans haven’t made any similar accommodations to their own measure yet.

5. Blocked sex ed resources for at-risk youth. And on top of legislators’ recent flurry of proposed abortion restrictions, the rest of the anti-choice community in North Dakota is also doing its best to remain hostile to women’s health. Even though North Dakota State University won a three-year federal grant to partner with Planned Parenthood to provide a sex education program for at-risk teenagers in the state, the school may be backing out of it after pressure from anti-abortion activists. The proposed sex ed program would have been voluntary, taken place outside of public school hours, required parental consent, and offered family planning resources. But anti-abortion activists decried the initiative, calling Planned Parenthood “an overt abortion industry that we don’t want to be a part of” — despite the fact that the Planned Parenthood affiliate in North Dakota doesn’t even perform abortion services.

Texas officials were so insistent on defunding Planned Parenthood, they dismantled the state’s federally-funded Women’s Health Program — a network of doctors that provide care for low-income women — so they could relaunch a new program excluding the national organization. But targeting Planned Parenthood comes at a steep price for the women seeking preventative care in Texas. Even though the state initially claimed their new program would have 3,500 participating providers for women to choose from, that list has now shrunk by nearly 1,000, leaving women in the state with even fewer options for their doctors.

Texas relaunched its state-run Women’s Health Program at the beginning of January. Even though the state has always maintained its new program will be able to meet the same demand as the old one did, that hasn’t proven to be the case so far. The first list of providers the state provided was inaccurate and confusing. And now that the state has released a revised list, the Texas Tribune reports it’s significantly smaller than promised:

The Texas WHP replaced the federal Medicaid WHP on Jan. 1. The program’s Affiliate Ban Rule, which prohibits providers associated with abortion clinics from participation, forced the exclusion of 50 Planned Parenthood clinics that participated in the former Medicaid program. Without Planned Parenthood, women’s health advocates have argued that the state will not be able to adequately serve low-income women enrolled in the program.

The HHSC had previously stated that the Texas WHP had 3,500 participating providers, roughly 1,000 more than the number of providers that participated in the former Medicaid WHP. That list has shrunk to 2,448 doctors and clinics, as 965 providers said they would not accept WHP patients, despite being certified for the program. The contact information for 700 other providers has also been updated on the state’s website.

From the beginning of Texas’ crusade against Planned Parenthood, there have been questions about the state’s ability to effectively relaunch its health program without federal funding. Last year, Gov. Rick Perry (R) convened a smoke-and-mirrors press conference to announce that the new Women’s Health Program was ready to go — even though it wasn’t.

Up to 50,000 women are being forced to search for new doctors this year now that they can no longer get their care at Planned Parenthood. To keep up with the increased demand from new patients, other providers in the Women’s Health Program may be forced to take up to five times the number of their usual Medicaid patients.