January 9, 2015 — Read the week's best commentaries from bloggers at Penn Law School, RH Reality Check and more.
INSURANCE COVERAGE: "Five States Allow Women's Health Medicaid Programs To Lapse," Dori Molozanov, Penn Program on Regulation's "RegBlog": Molozanov writes that the expiration of some Medicaid waiver programs at the end of 2014 means that "[w]omen in five states" -- Illinois, Louisiana, Michigan, Oregon and Pennsylvania -- "may be without affordable access to important health and family planning services, including routine cancer screenings and contraception." She explains that the states "chose not to ask CMS to renew" their Medicaid waiver programs, which allow states to "test new means of delivering health coverage under Medicaid, or to expand coverage to individuals who would not otherwise be eligible under federal law." The states' programs varied but generally had allowed them to offer no- or "low-cost reproductive services" to "women with incomes that do not exceed a certain amount above the Federal Poverty Level (FPL), but who do not qualify for [traditional] Medicaid." Of the five states, all but Louisiana have expanded Medicaid under the Affordable Care Act (PL 111-148), meaning that some "former beneficiaries of waiver programs in those states will likely receive the same low-cost services under Medicaid." However, they will "not be automatically transferred [to the program] and ... must reapply," and former participants who live in Louisiana or who exceed the income threshold for Medicaid eligibility must find other options. According to Molozanov, women's health advocates have expressed concern that "cancelling waiver programs and requiring women to reapply for health insurance will create gaps in coverage and leave many low-income women without necessary reproductive services" (Molozanov, "RegBlog," Penn Program on Regulation, 1/7).
HPV: "New HPV Vaccine Could Prevent Vast Majority of Cases of Several Cancers," Martha Kempner, RH Reality Check: Kempner writes that while FDA "last month approved a new version of ... Gardasil" that can "prevent 90 percent of cases of all cervical, vulvar, vaginal, and anal cancer," public health experts "stress that this can only happen if the vaccine becomes more widely accepted." Kempner notes that human papillomavirus "vaccines have been controversial since they were introduced," due in part to a "general movement against vaccinations" among some individuals, as well as a "fear that discussing [sexually transmitted infection] prevention with young teens and providing them with protection in the form of a vaccine will encourage sexual activity." In response, Kempner points out that data that were purported to show harm from vaccinations "have been thoroughly discredited" and that "[a] number of studies have found ... no difference in the behavior or beliefs of young people based on whether they have or have not been vaccinated." In addition, she points out that "[r]esearch shows the vaccines are working," noting that "states with high HPV vaccination rates had lower rates of cervical cancer, and vice versa" (Kempner, RH Reality Check, 1/8).
HYSTERECTOMIES: "Do You Really Need a Hysterectomy?" Amanda Hess, Slate's "XX Factor": Hess writes about a new study by University of Michigan and Wayne State University researchers showing that based on "the medical histories of more than 3,400 women who received hysterectomies at 52 hospitals across Michigan in 2013 ... nearly 1 in 5 of them may not have been necessary." According to the study, around 18% of the hysterectomies "weren't medically supported," and nearly 38% of women with benign conditions who underwent the procedure did not receive alternative treatment first, as recommended by the American College of Obstetricians and Gynecologists, she writes. However, Hess notes that "a dominant claim in press coverage of the story -- that 'nearly 1 in 5 women who undergo hysterectomy may not need the procedure' -- is not exactly true," as the study "excluded more than 2,600 women in a higher-risk category." She writes, "A hysterectomy is a choice that a woman should make with her doctor -- but it shouldn't be the only choice" (Hess, "XX Factor," Slate, 1/8).
ABORTION RESTRICTIONS: "Fifth Circuit Panel Peppers Attorneys With Tough Questions on Texas Abortion Law," Andrea Grimes, RH Reality Check: Grimes recaps Wednesday's oral arguments before a three-judge panel of the 5th U.S. Circuit Court of Appeals over the constitutionality of parts of a Texas antiabortion-rights law (HB 2) that could shutter many of the state's remaining abortion clinics if implemented. She writes, "Three issues appeared time and time again during the arguments," including whether the appeals court "should apply a 'rational basis' standard to evaluating the constitutionality of HB 2"; "whether the state could defend HB 2 as medically necessary while also suggesting that El Pasoans who are unable to travel to the interior of the state should simply drive into nearby New Mexico, where abortion restrictions are much looser"; and "whether established numerical parameters" -- such as driving distance to an abortion facility -- "could or should be established as automatic proof of an undue burden." She notes that the results of the trial "could direct the course of abortion-related law" across the U.S. as the country enacts "ever more onerous restrictions" on providers and as the Supreme Court mulls reviewing cases that "have been winding their way" through the lower courts (Grimes, RH Reality Check, 1/7).
What others are saying about abortion restrictions:
~ "4 Reasons Why the 5th Circuit Could Change Their Minds on the Texas Abortion Law," Robin Marty, Care2.
YEAR AHEAD: "Congress Introduces a National Abortion Ban on Its Very First Day Back," Tara Culp-Ressler, Center for American Progress' "ThinkProgress": "Republicans in Congress are wasting no time following through on the anti-abortion agenda the GOP laid out after winning significant gains in the 2014 midterm elections," Culp-Ressler writes, noting that GOP lawmakers on Tuesday introduced "a measure to ban abortions after 20 weeks." According to Culp-Ressler, the bill is "in direct violation of the protections afforded under Roe v. Wade" and counters medical consensus "that fetuses cannot survive outside the womb until about 24 to 28 weeks of pregnancy, which is considered to be the legal point of viability," and "cannot feel pain until after they are viable." Further, she writes that abortion-rights opponents believe that such "'fetal pain' measures represent a politically popular way of defining a policy that can force women to carry doomed pregnancies to term," given that most women who obtain abortions later in pregnancy are "in very desperate situations," such as fetal health problems (Culp-Ressler, "ThinkProgress," Center for American Progress, 1/7).
What others are saying about the year ahead:
~ "Heartbeat Bans, 72 Hour Waits and More Abortion Bills Coming in 2015," Marty, Care2.
ABORTION PROVIDERS: "This Doctor Moved Her Clinic to the Middle of the Ocean To Help Women Get Safe Abortions," Culp-Ressler, Center for American Progress' "ThinkProgress": Culp-Ressler writes about a new documentary, called Vessel, which highlights abortion provider Rebecca Gomperts' efforts to create a place where the "'only permission a woman needs'" to obtain abortion care "'is her own.'" According to Culp-Ressler, "Gomperts, a physician and former Greenpeace activist, made international headlines after launching the organization Women on Waves, which relies on the use of offshore spaces to advance abortion access." Gomperts "and her colleagues traveled to countries like Ireland, Poland, Portugal, and Morocco to help women use abortion-inducing pills ... to safely end an early pregnancy" (Culp-Ressler, "ThinkProgress," Center for American Progress, 1/8).