In what is likely to become one of his final official acts as leader of the free world, President Bush is having Department of Health and Human Services (HHS) revise the federal guidelines allowing employees of federally funded hospitals and clinics to refuse to provide or perform certain medical responsibilities due to "provider conscientious objections."
The new HHS rules will allow doctors, nurses, pharmacists or other health care workers to refuse to perform, assist, recommend or refer patients for contraception, sterilization and abortion services if it conflicts with their religious or moral beliefs.
The move is seen by many as a preemptive measure in anticipation of what many expect will be more women-friendly policies legislated under a Barack Obama Administration.
While a senator, President-elect Obama was an original co-sponsor of legislation to expand access to contraception, health information and preventive services aimed at reducing unintended pregnancies.
First introduced last January, the Prevention First Act is meant to increase funding for family planning under Title X and Medicaid; end insurance discrimination against women by forcing insurance companies to offer the same level of coverage for contraceptives as they do for other prescription drugs and services; insure that rape victims are given factually accurate information and immediate access to emergency contraception; and increase funding for teen pregnancy programs that are factually accurate and not "abstinence-only" based.
"People around here are finally exhaling, after eight long years," says Cecille Richards, Planned Parenthood Federation of America president. "Just think, the massive amount of time, energy and resources that the Planned Parenthood community had to spend shielding women and teens from the harm caused by the Bush Administration can now be directed to expanding women's access to the reproductive health information and services they urgently need."
Given that the Indiana state Legislature has introduced over 150 bills that would restrict or outlaw access to abortion in Indiana in recent years, including 20 such measures in 2008 alone, while addressing less than a dozen that would help prevent unintended pregnancy, advocates for women's health are hoping a change at the federal level will mean a change in Indiana as well.
"Planned Parenthood Advocates of Indiana is celebrating the election of Barack Obama, a pro-women's health president who will stand up for access to health care; comprehensive, medically accurate sex education; and a woman's right to choose," said Betty Cockrum, president of Planned Parenthood Advocates of Indiana (PPIN), following the recent presidential election. "This is an incredible day for health care.
"We believe the new administration will help the nearly 800,000 Hoosiers without health insurance get the coverage they need and ensure access to quality health care. We hope to see the return of nominal pricing, which would allow safety net health providers, such as Planned Parenthood health centers and college and university health centers, to again purchase low-cost birth control from manufacturers after suffering quadrupled prices for the past two years," Cockrum said.
"We also hope the new administration will put a stop to the proposed Health and Human Services' 'Provider Conscience' clause. The regulation could severely impede access to basic health care services and gut state laws and policies designed to ensure that individuals and families can obtain the health care they need."
PPIN is but one of the advocates hoping a Prevention First legislative package tops the state agenda when the General Assembly reconvenes in January.
"The package of bills would ensure medically-accurate sex education and protect birth control as we know it," according to Cockrum. "The attention focused on these issues during the election shows that the electorate is hungry for a solution."
The legislative agenda for 2009 will be dominated by property tax cuts and constitutional caps. But advocates of women's health hope some other types of business get done as well in the next state legislative session that begins in early January.
Access to contraceptives is critical to the prevention of unintended pregnancy and the reduction of abortion. Indiana ranks 49th in the country among states' efforts to prevent unintended pregnancy. Advocates of Prevention First hope to elevate Indiana's rating and the health of Indiana's families by protecting and promoting access to contraception.
In opposition to measures like President Bush's efforts at HHS, advocates of women's health are hoping that the state of Indiana will recognize that Hoosiers have a right to obtain and use safe and effective methods of birth control
"All across the country and right here in Indiana women are reporting problems in accessing contraception at their local pharmacies," according to Planned Parenthood Advocates of Indiana. "We've had numerous reports from women who have been denied their valid, legal prescriptions for birth control. In some cases the pharmacist confiscates the prescription. While we respect the views of others, including those of individual pharmacists who are morally opposed to birth control, access to contraception is critical for women who desire to plan their pregnancies."
Indiana prevention efforts
Here's what supporters of a Prevention First agenda would like to see accomplished in the next session of the Indiana General Assembly.
The requirement that pharmacies (as an institution, not individual pharmacists) must ensure that a patient's prescription be filled, or find and refer the patient to another pharmacy that will fill the prescription. If individual pharmacists oppose contraception or other drugs for non-medical reasons, they must report this to their employer in writing upon passage of the bill, and the pharmacy must make arrangements for its patients' prescriptions to be filled in a timely manner, either by ensuring that another pharmacist on staff can fill the prescription or referring the patient to another pharmacy that will fill the prescription.
Indiana spends more than $2 million each year on abstinence-only sex education programs, a practice some see as a contributor to teen pregnancy rather than a deterrent. To that end, proposed legislation as part of Prevention First will require that "Any recipient of state funding that provides information or offers programs regarding sex, family planning, pregnancy counseling or sexually transmitted diseases shall provide medically accurate, factual information that is age-appropriate and that includes information on both abstinence and contraception for the prevention of pregnancy and sexually transmitted diseases, including HIV/AIDS."
Medically accurate, factual information means that all medical, psychiatric, psychological, empirical and statistical statements provided are verified by scientific, peer-reviewed research and recognized as accurate and objective by professional organizations with expertise in the relevant field, such as the federal Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists.
For more go to www.ppin.org
Looking for an unusual, yet practical gift this holiday season? Planned Parenthood of Indiana (PPIN) is now offering gift certificates that can be given to women and men to cover the cost of essential services like screenings and birth control, as well as annual exams for women, which include breast exams and Pap tests.
The gift certificates can be purchased in increments of $25 online at www.ppin.org and in person at some Planned Parenthood centers. They can be redeemed at any of the 35 PPIN health centers around the state, no matter where they were purchased. The gift certificates are not just for the uninsured. PPIN does take some forms of insurance and the gift certificates could be used for co-pays or medication.