Please see attached a compilation of research and resources related to COVID and Repro Health. This is a non-exhaustive compilation of current, ongoing, and past research related to COVID and reproductive health, rights, and justice. We hope that it can offer a broad landscape of research and resources related to the impact of COVID on individuals, their families, and our communities. We aimed to pull research that relates and includes a diversity of populations and topic areas, while also keeping it manageable for review.
COVID-19 Resources
We hope you’re staying healthy and safe during our pandemic. Resources around us are limited, but we know sexual and reproductive health remains essential. Here is an ongoing list of resources compiled from our coalition members. We will continue to update this document as new resources become available.
To add to our list of resources, please send them to resources@reproductivefreedomca.org.
The Administration’s Attempt to Punish CA over Abortion Access
The Trump Administration is trying to bully California into decimating abortion access in the state. California has long required insurers to cover basic health care services, and in 2014 the state clarified that reproductive health care — including abortion care — is basic health care. With exceptions for some religiously-affiliated insurance companies, health plans in the state cannot treat abortion differently than other pregnancy-related care.
The Administration is now claiming that California’s policy violates the Weldon Amendment – a federal rule prohibiting local, state, and federal governments from requiring health care entities to cover, provide, or refer to abortion services. It doesn’t make sense. The Administration is singling out California – one of six states with this abortion coverage requirement. What’s more, this issue has already been decided! The Obama Administration rejected a similar challenge to California’s policy in 2016.
This is a pathetic attempt to punish the state of California for respecting the human right to health care. In the process, the Administration is threatening health care access for millions. Californians will not be bullied. We will not accept subpar plans denying people the full range of reproductive health care options. We will not accept insurance companies interfering in medical decision-making and reproductive freedom. Learn more from the resources below.
Factsheets and Resources
California Sets Example for Comprehensive Women’s Health Care Coverage
Notice of Violation from HHS and CA Response Letter (PDF)
Weldon Amendment, Consolidated Appropriations Act. HHS
Opinions, Blog, Commentary
HHS Issues Notice of Violation to California for its Abortion Coverage Mandate. HHS Press Release
Abortion is Basic Health Care. Phyllida Burlingame, ACLU NorCal
Trump’s Attack on Abortion Coverage in California Puts Politics Over Health. Dr. Jessica Beaman
Attorney General Becerra Issues Response to Trump Administration’s Baseless Allegations of Weldon Violation. Press Release.
From 2004: Attorney General Lockyer Readies Court Challenge to Fight Federal Attack on Women’s Right to Choose. Press Release. (with Pelosi and Boxer quotes)
News Articles
Trump administration threatens to cut health funding for California over abortion insurance law
The battle over abortion rights: Here’s what’s at stake in 2020
Editorial: Trump seeks a new fight with California on abortion
Trump threatens to cut California funding over abortion coverage
Separation of Abortion Payments in the Marketplaces
The Trump Administration is trying to make it more complicated and burdensome for health plans to cover abortion care. The rule impacts qualified health plans – health plans that are on the Affordable Care Act (ACA) Marketplace and include ACA protections, such as the essential health benefits and potential subsidies.
Federal policies, such as the Hyde Amendment, prohibit federal funds from covering abortion except in the limited circumstances. States, however, can allow or require health plans to cover the abortion care that pregnant people need. When that happens, insurers have to collect at least $1 per month as a premium covering abortion services. They then keep that $1 separate from the rest of the premium to ensure no federal funds are used for abortion services.
This rule takes that separation requirement to the point of absurdity. It requires insurers to send enrollees two separate bills – one for the abortion part of the premium and another for the rest of the coverage. Apparently it’s not enough for the insurer to separate the funds, now the enrollee must send two checks.The rule is dangerous. It stigmatizes abortion care, making it seem separate from other basic health care services. It could lead to confusion and people losing health care coverage. Additionally, the administrative and reporting burden will likely raise costs, leading to higher premiums or encouraging health insurance plans to drop abortion coverage all together. The rule goes into effect June 27, 2020 unless it is stopped in the courts first.
No Cost-Sharing for Abortions
The Trump administration is trying to chip away our access to basic health care — across the U.S. and in California specifically. Advocates and lawmakers in the state are not having it. Instead we have been working hard to enact progressive policies that advance reproductive freedom. One specific bill in the 2020 legislative session would eliminate insurance and deductibles for abortion services across the state. The bill would remove a significant barrier to care for people in California, ensuring that access to abortion services will not depend on how much money you have.
Background:
The ACA And Abortion Coverage
Title X
Strategies for Action
Resources and Information in support of mobilization efforts to protect Title X. Compiled by CCRF HealthCare Coverage Cmte.
Constituent Engagement
- Planned Parenthood. Take a minute to submit a comment to stop Trump-Pence from demolishing access to preventive and reproductive care.
- National Partnership for Women & Families. Submit a comment.
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Stop Trump’s Gag Rule. Generation Progress and Center for American Progress. Target audience: Young People. Factsheets, social media tools, and a comment submission portal.
Published Rules
- Federal Registry. Statutory Requirements of Title X of the Public Health Service Act and the Title X Appropriations Acts. Agency: Office of the Assistant Secretary for Health, Office of the Secretary, HHS. Comments Close 07/31/2018.
The Basics
- Title X: An Introduction to the Nation’s Family Planning Program. The National Family Planning & Reproductive Health Association (NFPRHA)
- The National Family Planning & Reproductive Health Association (NFPRHA) page on Title X with more information, including fact sheets, infographics, and a side-by-side comparison of the current Title X regulations with the recently released proposed Title X regulations
- Proposed Title X Regulations Could Significantly Impact Family Planning Care for Low-income Women. 2018 Kaiser Family Foundation.
- Side-by-Side Comparison. (NFPRHA)
- Use of Health Insurance Among Clients Seeking Contraceptive Services at Title X–Funded Facilities in 2016. Guttmacher Institute.
- Planned Parenthood – What is the domestic gag rule?
Title X in CA
- Title X Family Planning Program in California: Improving Public Health + Saving Taxpayer Dollars. Essential Access Health.
- The Title X Family Planning Program in California. National Family Planning & Reproductive Health Association. State-specific two-pager with statistics and infographics on the impact of Title X in California.
- Title X in California IMPROVING PUBLIC HEALTH AND SAVING TAXPAYER DOLLARS. State-specific fact sheet on the impact of Title X in California.
The Impact
- Impact of Family Planning Legislation. The University of Texas at Austin Texas Policy Evaluation Project. TxPEP link to their research on the impact of Family Planning legislation (includes all articles/press releases/briefs)
Specific articles and press releases that provide evidence of the impact of restricting Title X funding:
- Title X changes violate the AMA ethics code. According to the American Medical Association’s (AMA) Code of Medical Ethics, “truthful and open communication between doctor and patient is essential for trust in the relationship and for respect for autonomy.”1 The doctor’s role is to assist patients in making autonomous, informed decisions about their health care through counseling and to refer for care if the doctor cannot provide it. A new regulation proposed by the US Department of Health and Human Services would require providers in the Title X Family Planning Program to withhold information from patients and therefore violate the AMA ethics code.
- The Impact of Reproductive Health Legislation on Family Planning Clinic Services in Texas. Reserach article.
- Providing Family Planning Services at Primary Care Organizations after the Exclusion of Planned Parenthood from Publicly Funded Programs in Texas: Early Qualitative Evidence. Research article.
- New Research Shows the Impact of Defunding Planned Parenthood. Effect of Removal of Planned Parenthood from the Texas Women’s Health Program.
- Women’s experiences after Planned Parenthood’s exclusion from a family planning program in Texas. Assessed the impact on Depo shot (depot medroxyprogesterone) continuation when a large care provider was banned from a state-funded family planning program.
- What Texas’ Experience Tells Us About Planned Parenthood Defunding Plan. Opinion/Editorial By TxPEP Lead Investigator, Joseph Potter.
- Cutting Family Planning in Texas Research article.
Press Releases / Statements
- Health Affairs Blog. “A Domestic Gag Rule And More: The Trump Administration’s Proposed Changes To Title X”. Concise yet thorough summary of the issues at stake with the proposed Title X rules.
- CA Attorney General. Letter from the CA Attorney General to federal administration opposing the proposed Title X rules.
- National Health Law Program. “Trump HHS Rule Targets Federal Funding for Women’s Health Care”
- Guttmacher Institute. “Most Contraceptive Patients at Title X–Funded Health Centers in 2016 Had Insurance Coverage and Planned to Use It to Pay for Services”.
- An Abortion Provider Explains What’s Really at Stake With Changes to Title XFunding. Diane Harvath-Cosper. Self. June 21, 2018
Federal Funding / Appropriations
- House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) draft spending package for fiscal year (FY) 2018-2019. Eliminates Title X funding and blocks PP health centers from receiving federal funding.
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Anti-Choice Lawmakers Use Federal Budget Bills to Launch All-Out Assault on Reproductive Rights (Updated). Rewire.News.
The Impact of Public Charge
The NEW Proposed Public Charge Rules
- The Trump Administration published a Notice of Proposed Rule Making for the “public charge” immigration rule.
- Under the current public charge rule, immigrants who are in need of long-term care or cash assistance can be denied visas or legal permanent residency.
- The new rule proposes to extend denials to immigrants for a wide range of programs and services including Medicaid, food aid, and public housing.
- If approved, the rule could deter millions of low-income immigrant individuals and families from applying for and accessing critical services, including sexual and reproductive health care.
- Public comments on the proposed rule can be submitted through December 10th.
CCRF Nov 19 Presentation: Priscilla Huang, Senior Attorney, National Health Law Program – Los Angeles and Sylvia Castillo, Senior Manager of Government + Community Affairs, Essential Access Health
Sample talking points
National Asian Pacific American Women’s Forum (NAPAWF), National Latina Institute for Reproductive Health (NLIRH), In Our Own Voice: National Black Women’s Reproductive Agenda and National Women Law Center (NWLC)
Writing Comments: Tips and Best Practices
- Make 30 percent of your comments unique.
- Don’t mention programs that are not included in the NPRM.
- Don’t suggest fixes.
- Attach/upload the research, data, etc. you cite.
- Comments must be submitted in English or accompanied by an English translation.
- Commenting is not a lobbying activity.
- You are an expert!
Citing your Research
It has been brought to our attention that any cited research should now be attached to your comments. In addition to the inserting links, you should have as an appendix digital copies of the actual reserach papers, reports, etc. (Yes, that means that your comments can be dozens of pages long).
- Research Estimating Impact of Proposed Public Charge Rule: What Study to Use? – Protecting Immigrant Families (PIF)
- Slidedeck Presentation – THE UCLA CENTER FOR HEALTH POLICY RESEARCH