If you’ve read the headlines over the past few months, you’ve probably heard about the Zika virus. You might wonder how serious the virus is and what steps you can take to help protect yourself and your family.
HHS is committed to giving the American people the tools they need to live healthy and productive lives. And information can often be one of the best tools. So I want to share with you some of the things we have learned about this virus, and what you should know.
What is Zika?
Zika is a virus that is primarily spread by mosquitoes, though it can also be sexually transmitted. As of July 20, there have been 5,200 cases of Zika in the United States and its territories.
The biggest risk of Zika is to pregnant women or women of childbearing age. Zika virus can cause a serious birth defect called microcephaly, as well as other severe fetal brain defects.
Zika can cause symptoms including fever, rash, joint pain, or red eyes. An illness from Zika is usually mild, and the symptoms typically will only last several days to a week. Based on previous outbreaks, approximately 80 percent of people who have Zika will not have any symptoms.
How Do I Prevent Getting Zika?
Our colleagues at the Centers for Disease Control and Prevention have laid out helpful prevention guidance, which you can find right here. This is particularly important if you travel to an area with active Zika transmission. It is important to remember to follow the guidance not only when you are in an area with active Zika transmission, but also for three weeks after you return.
Pregnant women should not travel to areas with active Zika transmission. If you’re pregnant and you have traveled to an area with Zika, you should visit your doctor or other health care provider as soon as possible, even if you don’t feel sick. This checklist offers some topics and questions you should bring up.
Another way you can prevent Zika is by preventing the most common way Zika spreads – mosquito bites. You can reduce your risk of being bitten by:
Wearing long-sleeved shirts, and long pants when outside.
Emptying containers that collect water, or notifying the proper authorities if you see places where water has collected. The most common type of mosquito that spreads Zika can reproduce in as little water as a bottle cap.
What Is All This Talk About Funding?
Back in February, the Obama Administration asked Congress for $1.9 billion to fight Zika and protect pregnant women. It was a request based on the advice of our most experienced public health experts.
These funds would be used to protect pregnant women in the United States by better controlling the mosquitoes that spread Zika, by developing new tools like vaccines and better diagnostics, and by conducting crucial research so we can better understand the effects of Zika, especially on infants and children.
Congress recently left Washington without providing these additional funds. At HHS, we’re going to do everything we can to prevent, detect and respond to this virus here in the United States, and especially in hard-hit places like Puerto Rico, but hope there is action on this necessary funding as soon as the Congress returns.
How Can I Help?
We are always stronger against public health threats when we work together. So the best thing you can do right now is to make sure more people get more information on the Zika virus.
Help us reach others by sharing this blog post on Facebook and Twitter. Click the “Share” button in the top right corner of this post, or click the “Tweet This” button at the bottom.
And share this information with your family, friends, neighbors, and coworkers. Make sure that everyone knows the risks, and how to stay safe.
A number of folks in Humboldt County have expressed complaints about our local hospital, but they should be thankful for the secular hospital we have available to serve our population. Given the merger-mania in corporate America, we could be facing, like so many other communities, a takeover of our hospital by Catholic Hospitals of America and the imposition of OBGYN-lite policies, restricting the availability of reproductive healthcare services to women throughout the hospital’s service area.
Here’s a post an article from ThinkProgress that will walk you through how religious institutions are imposing their religious beliefs on women through the limited care they’re willing to provide, essentially elevating their religious rights at the expense of any patient’s rights.
When Rita, a Michigan-based OB-GYN, learned that the hospital where she worked would be switching hands, she was dismayed.
The secular community hospital, Crittenton, had plans to join with Ascension Health, a prominent Catholic nonprofit hospital chain. Rita, who asked that her real name be withheld to protect her identity, knew the transition would profoundly impact her ability to do her job the way she saw fit. The OB-GYN specifically wanted to work at a place where she could practice the full scope of reproductive care, from preventing pregnancy to delivering babies. But now, with the hospital merger looming in the not-so-distant future, that possibility seemed increasingly unlikely.
Rita also understood the change in leadership meant that her patients’ medical options would be limited. That’s because Catholic hospitals follow a set of rules written by the U.S. Conference of Catholic Bishops, which often prohibit doctors from performing basic reproductive services — like contraception, sterilization, in vitro fertilization, abortion — and end-of-life care.
Although Rita knew certain services at the hospital would soon be banned, many of her patients had no idea. They also may not have known that mergers like Crittenton’s are becoming increasingly common.
As hospitals throughout the country struggle with financial woes, many have begun to merge with Catholic systems in order to stay in business. This means a growing number of patients are winding up in institutions guided by religious doctrine. Between 2001 and 2016, the number of hospitals affiliated with the Catholic Church increased by 22 percent. Today, one in six patients in the U.S. is cared for at a Catholic hospital — a troubling trend for health care providers like Rita, who worry that patients are increasingly being placed in centers that provide services based on faith rather than medical necessity.
“I do think as more places are being purchased by Catholic systems it’s going to become more of a problem,” she told ThinkProgress. “To take away the ability to provide services that people need or desire… I think it’s very upsetting both for an OB-GYN and also for a woman. Having those choices gives you the ability to participate in society.”
Rita found another job before the Catholic system moved in. Although she says her decision to leave Crittenton was based on other factors, she admits she probably would have sought employment elsewhere even if those reasons hadn’t come up. Before Rita departed from the hospital, though, she warned her patients about what was to come — and encouraged them to get their tubes tied before it was too late.
As Rita was advising her patients to move forward with their procedures, organizers with the American Civil Liberties Union of Michigan were trying to gin up support for a campaign opposing the Crittenton merger. In June, they arranged an event at a public library in a nearby town to talk about what the shift in leadership would mean for community members. But only six people showed up. “It was so hard for us to connect to anyone who cared,” said Merissa Kovach, a field organizer in charge of the campaign.
The struggle to engage people who could be directly impacted by Crittenton’s transition might not be entirely surprising given the demographic makeup of Rochester, which is predominantly white, conservative-leaning, and upper-middle class. But it suggests another problem that Kovach and others have been struggling to address: A widespread lack of awareness about a conflict that’s quietly brewing in the health care industry. It’s a trend that has managed to accelerate rapidly and yet evade public scrutiny. Because Catholic hospitals aren’t required to disclose their religious affiliation or talk about the limited medical services they may offer, many patients wind up in the dark — and don’t think about the hierarchies that govern their care until it’s too late.
In Rochester, for example, the two systems merged without much of a fuss. But just a few days after Ascension took over the hospital in October 2015, its official website changed ever so slightly. “Tubal ligations” were removed from the list of available services.
The role of Catholics in health care is nothing new — indeed, throughout the Middle Ages, it was the Catholic Church that created hospitals and hospices for the old and ill in an attempt to follow Jesus’ teachings about healing the sick. Many of the earliesthospitals in America were set up by Ursuline sisters and other Catholic orders dedicated to serving the poor. About 75 Catholic hospitals had been established in the U.S. by 1875.
But there has been a particular boom in the number of Catholic hospitals since the beginning of the 21st century, according to a groundbreaking 2013 report on the growth of Catholic hospitals and health systems by MergerWatch, a patients’ rights organization that tracks hospital mergers, and the American Civil Liberties Union (ACLU). In 2001, about 8.2 percent of the nation’s acute care hospitals were Catholic nonprofits. By 2011, that number had jumped to 10.1 percent. This increase coincided with notable drops in the numbers of other nonprofit hospitals and public hospitals.
This trend is accelerating among all hospital chains, too, and not just nonprofits. A recently released 2016 update found that 14.5 percent of all acute care hospitals are now Catholic-owned or affiliated (up from 11.2 percent in 2001) and that four of the nation’s 10 largest hospital systems are Catholic-sponsored. Some of the growth is the result of new Catholic hospitals opening their doors — but many were the result of secular hospitals merging with Catholic systems, bringing them under the Catholic hospitals umbrella.
But while Lois Uttley, MergerWatch’s director, believes Catholic hospitals do deliver “excellent care” in many treatment areas, she and her group are working to shine a light on a major exception. They believe Catholic hospitals prevent many women from getting the reproductive health care they need — even procedures that are medically necessary — ultimately putting them in an untenable situation once they walk through the doors of one of these religious facilities.
Once a hospital elects to merge with the Catholic system, it agrees to obey a set of directives issued by the U.S. Conference of Catholic Bishops. Called the “Ethical and Religious Directives for Catholic Health Care Services” (ERDs), these rules include instructions that Catholic care “should distinguish itself by service to and advocacy for those people whose social condition puts them at the margins of our society and makes them particularly vulnerable to discrimination: the poor; the uninsured and the underinsured; children and the unborn; single parents; the elderly; those with incurable diseases and chemical dependencies; racial minorities; immigrants and refugees.”
Although these large Catholic hospital systems operate in accordance with religious values and doctrine, they aren’t directly funded or controlled by the Catholic Church. As Uttley put it, “they are not being funded by the envelope my mother used to put in the collection basket every Sunday.”
Instead, as tax-exempt nonprofit corporations, they are funded through a combination of private insurance reimbursement, Medicare and Medicaid payments, and sometimes government grants, according to Uttley.
By bringing many hospitals together into large Catholic health systems, they can cut costs through shared administration and joint purchasing, offering protection to hospitals in rural states where isolated health care facilities often struggle. “It’s to their credit, they’ve kept these hospitals operating in very challenging times,” she said.
But the directives also include prohibitions on abortion, even when a woman’s health is at risk; assistance with surrogacy; egg and sperm donation; contraception; and temporary or permanent sterilization, with few — if any — exceptions. And the condoning of or participation in euthanasia or assisted suicide “in any way” is expressly verboten for all who work at a Catholic health care institution. MergerWatch, the ACLU, and the handful of other organizations that track this issue believe these directives often mean even procedures needed to mitigate serious health risk to the patient are unavailable at a Catholic hospital.
The groups also pointed to a troubling lack of transparency: Because Catholic hospitals often choose not to disclose which services are not offered, patients don’t always realize they operate any differently from a secular institution.
Proponents of the Catholic hospital system say the distinction should already be obvious to patients given the facilities’ religious presentation. As the attorney for one Catholic hospital in California that refuses to perform tubal ligation argued in a lawsuit earlier this year, “no one is lacking for understanding that this is a Catholic hospital, from the crucifix in the front entrance to everything about it.”
But that’s not necessarily how providers see it. Nancy, a physician who provided services at Rochester’s Crittenton before the merger and continues to do so today, said the now-Catholic hospital is presented to the public as a secular institution with no disclosure of its restrictions. “I think it is incredibly difficult to understand what limits we have available,” said Nancy, who asked that her real name be withheld because she is still practicing in the field, noting that the names of Catholic hospitals don’t always reveal their religious affiliation. “It’s not Saint Crittenton. It’s not Mary of Christ Crittenton. It’s just Crittenton.”
Ascension and Crittenton did not respond to a ThinkProgress inquiry about their practices. A spokesperson for the Catholic Health Association, which represents hundreds of Catholic hospitals and facilities nationwide, said his group “encourages transparency from Catholic hospitals regarding the services they do and do not offer.”
But Brigitte Amiri, senior staff attorney for the ACLU’s Reproductive Freedom Project, says in practice, that transparency is often absent — putting patients in potentially perilous situations when they’re in urgent need of care.
“The hospital closest to you might be Catholic, you might not know it, you might not think to ask these questions until [you’re facing] an emergency situation or far along in a pregnancy,” she said.
Rachel Miller found herself in that exact situation when she was a patient at Mercy hospital in Redding, California in 2015. Miller, who was pregnant with her second child, was certain she didn’t want to have more kids: In 2013, she had an emergency C-section for her first daughter, and knew she would have to repeat the procedure for the birth of her second child. After she discussed her options with her OB-GYN, she decided a tubal ligation made the most sense — she could get it right after delivering her baby and it wouldn’t require an additional hospitalization.
Miller sent a request to Mercy for the procedure, and assumed it would be approved. Instead, she received a letter back stating Mercy would be unable to accommodate her, citing the Catholic bishops’ directives.
Miller had never heard of the directives before — in fact, she had no idea that the standard of care at Mercy would be any different than what was available at a secular hospital. “I guess if someone had asked me at the time, ‘is this a Catholic hospital?’ I would have said yes, because it’s Mercy, normally a Mercy hospital is Catholic,” she told ThinkProgress. “But I had never thought about it. And as far as Catholic hospitals in general and having ERDs, I had never thought about that either.”
Miller was sure she wanted to get her tubes tied, but after Mercy’s rejection, she found that her options were limited. Redding has only one hospital with a labor and delivery department and the nearest hospital Miller could find that took her insurance was some 160 miles away. That was out of the question — Miller knew she would have to stay at the hospital for several days, and she didn’t want to be away from her toddler for that long. Mercy — the largest hospital provider in California — was her only option, and they just wouldn’t budge.
That was especially concerning to Elizabeth Gill, an attorney at the ACLU of Northern California who later took up Miller’s case. “It’s troubling that your access to health care in such a significant degree in a state like California is dictated by the moral code that corporations subscribe to, especially given that these are entities that are largely state and federally funded,” she said.
The predicament Miller found herself in is becoming increasingly common.
For many patients, Catholic hospitals are now so ubiquitous they may be the closest or only option for care. According to MergerWatch’s most recent report, more than 40 percent of the acute care beds in Alaska, Iowa, Wisconsin, Washington, and South Dakota are in Catholic-owned or affiliated hospitals, and more than 45 Catholic hospitals in the country provide the only acute care in their geographic region. Naturally, this impacts the services available to patients. As Miller experienced, the bishops’ guidelines often prevent doctors from performing tubal ligations after patients deliver, which is the safest time for the procedure.
Moreover, as the National Women’s Law Center noted in a complaint to the Centers for Medicare and Medicaid Services, many Catholic hospitals don’t follow the medical standards of care for what’s known as “miscarriage management,” often by denying services to women experiencing pregnancy complications before viability or in the middle of a miscarriage.
Tamesha Means was 18 weeks pregnant when she showed up at a Mercy hospital in Michigan in December 2010. Her water had broken prematurely. Hospital staff examined Means, but neglected to tell her that the fetus she was carrying had virtually no chance of survival — and in fact posed a risk to her health if she continued to carry it. Means was sent home, but she returned the next day as her bleeding and cramps intensified. Again, she was instructed to go home. Means returned for a third time that night — visibly in pain and showing signs of an infection. The hospital prepared to send her home once again, but stopped when she started delivering. The baby died shortly thereafter, and the hospital staff told Means to prepare funeral arrangements.
The ACLU took on the case, arguing that the directives prevented hospital staff from informing Means of the risk of the pregnancy and directly placed her in harm’s way. “Because of the Directives, MHP did not inform Ms. Means that, due to her condition, the fetus she was carrying had virtually no chance of surviving, and continuing her pregnancy would pose a serious risk to her health,” the lawsuit claimed. As a result, “Ms. Means suffered severe, unnecessary, and foreseeable physical and emotional pain.”
The restrictions on care don’t present a burden for patients alone — working within the system can also weigh heavily on providers who are prevented from performing the full range of medical care they expected to practice as an OB-GYN. According to a 2012 national survey, more than 50 percent of OB-GYNs who work at Catholic hospitals said they’ve run into conflicts with their institutions over the directives. Dr. Didi Saint Louis, a physician in the Southeast who completed her medical residency at a Catholic hospital, is familiar with that tension herself. She remembered seeing a patient who fell extremely ill at an early stage in a nonviable pregnancy. Saint Louis was prohibited from terminating the pregnancy — even though the fetus would not survive — and ended up transferring the patient to another hospital.
“I remember our director riding in the ambulance with the patient, she went straight to the operating room, they terminated the pregnancy, and she was fine,” she recalled. “But it could have gone so many different ways. And while the Catholic hospitals strive to give the best standard of care, this is one area where I think they fall short.”
The impact of a hospital merger can be much more profound for people living in geographically isolated regions without easily accessible alternatives. According to MergerWatch, there are 46 hospitals nationally that provide the only short-term acute care for people in their region, leaving people who lack transportation and travel resources with few alternative options.
Nancy, the physician from Michigan who works with Ascension, says she’s fortunate to be in a region with more than one hospital. “I’m in an area in which my patients can commute or get to a different location, so people in more remote areas are stuck without that,” she said. “Which is a really disturbing trend.”
About 2,000 miles west of Rochester, a Catholic hospital merger brought a very different outcome. In Washington, a battle was waged over the fate of Vashon Island’s only health clinic. Vashon, a quirky island community near Seattle, is home to about 11,000 people, 45 miles of shoreline, and an unofficial mayor who was re-elected in 2015 over a goat named Bandit. It is a Democratic bastion: Mitt Romney received a mere 18.6 percent of the vote in the 2012 elections, to Barack Obama’s 77.6 percent.
In 2012, Mark Benedum, the CEO of the island’s health clinic, announced the board had decided that, due to financial struggles, the time had come “to explore the benefits of joining a larger system.” It reached an agreement to become an affiliate of Franciscan Health System, a chain of Catholic health facilities and part of the behemoth Catholic Health Initiatives.
Benedum initially claimed patients’ options would be unaffected by this union, insisting, “it’s not going to change a thing.”
Vashon’s residents weren’t so sure. A group of skeptics, calling itself Vashon HealthWatch, worried that the island’s sole clinic would now be forced to adhere to the bishops’ directives — and that their care would be limited as a result. After consulting with MergerWatch, they organized a massive town hall meeting where members of the community could question Franciscan and Highline leadership.
On April 25, 2013, weeks after the Franciscan’s purchase of the clinic was complete, about two hundred people packed the multipurpose room at one of the the island’s schools, according to Kate Hunter, who helped organized the event. It was a far cry from the sparsely attended event that took place in Michigan. And not only did people show up, but they’d read the directives and were prepared with specific questions.
Benedum and executives from Franciscan Health Services were peppered with two hours of anxious inquiries from community members about the merger’s impact on available reproductive health and end-of-life services.
Margaret Chen, a staff attorney with the ACLU of Washington Foundation, said this level of civic engagement is atypical. “The visibility of concerned citizens was large in the Vashon Island community, maybe in part because of the unique situation [of being so separated from other options].” This response, she suggested, might have been part of the reason the new ownership agreed to continue offering birth control, family planning, and contraception to patients on the island — though a company spokesperson said the directives are “consistently applied” across all of its facilities.
While the executives sought to assure residents that “nothing is going to change at the Vashon medical clinic,” Hunter wasn’t convinced. She recalled one particularly concerning exchange toward the end of the forum: “Does your contract with your doctors specify that they will follow the directives?” a resident asked. “Yes, they do,” the Franciscan representative answered. “Our employment contract does.”
John Jenkel, who is part of the Vashon-Maury Health Collaborative, a community group that works to improve emergency care options on the island, said the relationship between the new ownership and residents was scarred by that early tension. “[T]hose directives and the manner in which the Franciscans communicated with the community caused a rift that never really made for a comfortable working relationship on our small island,” he said. “The initial discussion that the Franciscans had with the community was a rocky one, and the relationship of the directives to the type of care the Franciscans would be providing was never too clear.”
Hunter stopped going to the Vashon clinic. “I just feel so strongly that no one’s religious beliefs should interfere with my health care and I had no confidence that that would not be the case at the clinic anymore,” she said. Instead, she travels to a secular nonprofit facility in Seattle, via ferry and bus — a 60- to 90-minute trip each way.
When ThinkProgress reached out to Franciscan for comment, spokesperson Scott Thompson said that “none of the practice’s women’s reproductive services changed at the clinic after Highline’s affiliation with CHI Franciscan Health.” However, he added that the Vashon Island clinic would be closing in August. The company attributed the decision to the cost of operating the clinic and the fact that visits had declined from about 1,000 a month when they took it over to between 750 and 850 a month today.
Kate Hunter laments that with the closing, “there will be no health care clinic on Vashon Island. We’re back to ground zero.”
The bishops’ directives were last updated in 2009 and, according to observers, are due to be revised again in the near future. Reproductive rights advocates say a revision could loosen restrictions on how hospitals that become Catholic through mergers may deal with reproductive decisions — or could put the kibosh on the limited flexibility that Catholic chains have shown in places like Vashon Island.
Sara Hutchinson Ratcliffe, domestic program director for Catholics for Choice, fears it will be the latter. “I think the upcoming regulations are going to close those avenues for alternative provision for those health care services, to make the partnership agreements even more strict on who must/must not do this or that,” she said. “I think it will make it worse.”
MergerWatch’s Lois Uttley is a bit more optimistic. “We hope that they will be realistic about the fact that, in this day and age, Catholic hospitals are serving everyone in the community, not just Catholics. And they are employing doctors and staff that come from a wide background of religious affiliation,” she said. “We hope there will be a recognition that all hospitals, including Catholic ones, are licensed to serve the whole community.”
The press office for the U.S. Conference of Catholic Bishops did not respond to a ThinkProgress inquiry about their timetable for an update. But when and if the directives are updated, they could make a huge difference in terms of whether doctors at hospitals that merge with Catholic hospital system.
In the meantime, several approaches have been contemplated for how to address the topic.
The Center for Inquiry, which advocates for a secular society, thinks that the Medicare and Medicaid funding Catholic hospitals receive could be used as leverage to force Catholic hospitals to provide a full range of reproductive health and end-of-life care. Michael De Dora, who heads the Center’s Office of Public Policy, explained that while he does not believe all individual doctors should be forced to engage in all health care services, all hospitals should. “The responsibility should be with the hospital in any case [if] they’re receiving public funds,” he said. “That is the ideal.”
The ACLU’s Brigitte Amiri noted that some — though not many — states have considered legislation that would shield doctors from punishment, should they choose to provide services forbidden under the directives. After non-discrimination laws and same-sex marriage equality were enacted, severalCatholic Charities organizationsshelvedadoption services rather than serve same-sex couples.
Thus far, the ACLU has concentrated its efforts on the judicial system, threatening and bringing lawsuits under the federal Emergency Medical Treatment and Active Labor Act and state medical laws. Twosuitsweredismissed at the trial court level, though both are being appealed, and others are still working their way through the courts. In April, for the first time, the 41,000 doctors of the California Medical Association announced they would join an ACLU of Northern California case against a Catholic hospital system that bars its doctors from performing tubal ligation.
Since these and other attempts to force Catholic hospitals to provide services have not yet been met with much success, some activists have focused on making the rules more transparent.
Washington state enacted a requirement that hospitals generally disclose what services they refuse to provide to the state government — which would become public record — but MergerWatch’s advocacy coordinator, Christine Khaikin, observed even that “leaves a lot of room for interpretation to the hospital system,” and few hospitals have reported much of anything.
The American Atheists, a group that advocates for a strict separation of government and religion, have circulated a piece of model state legislation called the Patient’s Right to Know Act. The organization’s national legal and public policy director Amanda Knief said it would simply require that providers “inform their patients up front of all services they’re not going to provide, according to their religious, philosophical beliefs.” This “sunshine law” would not require hospitals to provide an explanation or a referral, she added, but simply a disclosure of which services are not provided there “because we’re Catholic affiliated, or we’re Pastafarian affiliated, or we don’t believe in modern medicine.”
The bill has been introduced in Arizona, and Knief is hopeful other states will soon follow. But, she acknowledges, it may have trouble gaining momentum — some progressive groups have been reluctant to back the measure because it lacks a requirement that the hospital refer the patient to a place that performs procedures prohibited by the directives.
In some communities, MergerWatch has partnered with local advocates to utilize state hospital merger laws and galvanize public actions to force accommodations or block the mergers entirely. “Frankly, totally stopping the merger is our fallback position,” Lois Uttley explained. “What we try to do, from the outset, is make sure that community access to needed reproductive health care services is preserved in some way.” She pointed to one case in which a separately funded and staffed reproductive health care center was opened on the second floor of a newly Catholic hospital that could no longer provide all services under the directives. In another, the community got a local hospital to call off its plans to affiliate with a Catholic system.
But, like with Crittenton Hospital in Michigan, these mergers often fly under the radar. Because the hospitals themselves do not highlight that they are going to begin restricting services, MergerWatch, the ACLU, and a small number of other organizations are often the only early-warning system for communities. And, as Sara Hutchison Ratcliffe of Catholics for Choice pointed out, until more people understand what these mergers mean, it can be an uphill battle for them to galvanize community resistance.
“Awareness isn’t the only solution, but it is the first step,” she said. “Until they are aware, the likelihood of something happening is small… The first step is getting those who have the power to change it involved.”
The fate that awaits Rochester, Vashon, and the numerous other communities that have recently experienced hospital mergers is uncertain. Indeed, some may choose to go the path of resistance favored by Washington’s quirky island community, organizing themselves and arranging well-attended town hall meetings. But, as Merissa Kovach and her coworkers at the ACLU of Michigan experienced while organizing their campaign, getting that community buy-in is often an uphill battle.
“One of the biggest issues with this is that it’s just not well-known at all and nobody understands what these hospitals are doing,” Kovach said. “We’re in such a public education step with this, and it’s such an unknown issue. People don’t know why they should care.”
But why did they seem to know and care in the Washington island? At least some portion of the differences between the two community responses can likely be drawn along political lines — Vashon overwhelmingly leans left, Rochester tilts right. But what took place in the Michigan city might be the more standard course of events: A merger takes place in a community that isn’t predisposed to fight it — or isn’t even aware that it might impact the care they expect to receive — and, as was the case with Rochester, a new merger quietly goes into effect. And the cumulative impact of these mergers, critics say, is an overall reduction in available reproductive services.
So what are the alternatives to Catholic medical care? In some rural communities, there aren’t any — it’s a Catholic system or nothing at all. That’s a sobering reality for people on all sides of the debate, including reproductive health advocates. They recognize that a singular focus on the expansion of the Catholic health care system ignores the forces that often propelled them to step in in the first place. Public hospitals are struggling, and their Catholic counterparts can provide much-needed care. According to the most recent MergerWatch report, the number of public short-term acute care hospitals in the U.S. dropped an astonishing 34 percent between 2001 and 2016. The number of secular nonprofit hospitals, too, shrunk by 11 percent, while for-profit systems shot up by more than 50 percent. In rural areas, where it is harder to turn a profit, these trends have left tremendous disparities in health care access.
Catholic hospitals help fill some of that gap — but at what cost? The ACLU’s Brigitte Amiri worries that hospitals’ fealty to the directives over the standard of care means that for some, the delta between the services they seek and those that are available is becoming a gulf.
“We don’t want to take away health care services from a community that desperately needs them,” she acknowledged. “But I don’t think we can be so timid about our work that we don’t push them to provide health and lifesaving care to women.”
Kiley Kroh and Tara Culp-Ressler edited this piece. Cory Herro provided research assistance. Videos by Victoria Fleischer, graphics by Dylan Petrohilos, and illustrations by Laurel Raymond.
Republicans, in both the House and the Senate, are currently colluding to gut Healthcare Reform and deny actual healthcare to millions of women across our nation using a process called Reconciliation. Reconciliation is an expedited budgetary process that offers some procedural advantages: it needs only the support of a simple majority in the Senate, and cannot be filibustered. The bill they intend pass via reconciliation is HR3762, inappropriately named, “Restoring Americans’ Healthcare Freedom Reconciliation Act” … it should be named “Butchering All Hope of Being Able to Afford Effective Healthcare Act.”
This reconciliation bill includes language to repeal key parts of Obamacare: the individual mandate, the employer mandate, the medical device tax and the ‘Cadillac tax.’ There are press posts saying that it will also end the Independent Payment Advisory Board (IPAB), but I can’t find such a provision in the bill.In addition, it would defund Planned Parenthood for one year
Defunding Planned Parenthood for a Year—
Here’s the section which specifically codifies the vilification of Planned Parenthood as a “Prohibited Entity” that just happens to provide “essential” healthcare for millions of women across our nation:
SEC. 202. FEDERAL PAYMENT TO STATES. (a) In General.—Notwithstanding section 504(a), 1902(a)(23), 2002, 2005(a)(4), 2102(a)(7), or 2105(a)(1) of the Social Security Act (42 U.S.C. 704(a), 1396b(a)(23), 1397a, 1397d(a)(4), 1397bb(a)(2), 1397ee(a)(1)), or the terms of any Medicaid waiver in effect on the date of enactment of this Act that is approved under section 1115 or 1915 of the Social Security Act (42 U.S.C. 1315, 1396n), for the 1-year period beginning on the date of the enactment of this Act no Federal funds may be made available to a State for payments to a prohibited entity, whether made directly to the prohibited entity or through a managed care organization under contract with the State.
(b) Definition Of Prohibited Entity.—In this section, the term “prohibited entity” means an entity, including its affiliates, subsidiaries, successors, and clinics—
(1) that, as of the date of enactment of this Act—
(A) is an organization described in section 501(c)(3) of the Internal Revenue Code of 1986 and exempt from tax under section 501(a) of such Code;
(B) is an essential community provider described in section 156.235 of title 45, Code of Federal Regulations, that is primarily engaged in family planning services, reproductive health, and related medical care; and
(C) provides for abortions, other than an abortion—
(i) if the pregnancy is the result of an act of rape or incest; or
(ii) in the case where a woman suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the woman in danger of death unless an abortion is performed, including a life-endangering physical condition caused by or arising from the pregnancy itself; and
(2) for which the total amount of Federal and State expenditures under the Medicaid program under title XIX of the Social Security Act in fiscal year 2014 made directly to the entity and to any affiliates, subsidiaries, successors, or clinics of the entity, or made to the entity and to any affiliates, subsidiaries, successors, or clinics of the entity as part of a nationwide health care provider network, exceeded $350,000,000.
Please note that the provisions to completely eliminate any funds for Planned Parenthood were proposed and recommended by the Ways and Means Committee currently led by Rep. Paul Ryan, that same Paul Ryan who will is expected to be elected as Speaker of the House next Wednesday — that is, unless the right wing extremists of the Republican Freedom Caucus renege and cast their votes for their beloved Rep. Daniel Webster instead.
Repealing the Individual and Employer Mandates —
Repealing individual mandate provisions are likely to increase, rather than decrease, the number of U.S. residents without health coverage, thus eliminating the progress that has been made in holding people responsible for their healthcare. If the CBO forecasts are correct, the H.R. 3762 mandate repeal provisions could increase the number of uninsured U.S. residents by 55 percent to 65 percent. But, that’s okay with Republicans because for each person who doesn’t buy health insurance, the government doesn’t have to shell out $760-$815. But they took it one step further. To help their corporate benefactors, they also plan on repealing the mandates on employers to provide medical coverage. Thus, ordinary Americans seeking to access affordable healthcare coverage for themselves and their families are going to rapidly find themselves up the proverbial creak, with no paddle, a leaky boat and no pail with which to bail out their boat.
The house voted on passage of HR3762 on Friday. The vote was 240-189 with 5 Democrats not voting. One Democrat (Peterson) voted for passage and ALL THREE of Nevada’s Congressional Republicans voted ‘AYE’ for passage! The bill is now off to the Senate, where it can be considered without a 60-vote cloture requirement (assuming the package passes muster with the Senate “Byrd Rule.”).
The Byrd Rule is a Senate rule that amends the Congressional Budget Act of 1974 to allow Senators, during the Reconciliation Process, to block a piece of legislation if it purports significantly to increase the federal deficit beyond a ten-year term or is otherwise an “extraneous matter” as set forth in the Budget Act. It is named after West Virginia Senator Robert Byrd.
Including macroeconomic feedback, CBO and JCT estimate that enacting the legislation would increase net direct spending as well as on-budget deficits by more than $5 billion in one or more of the four consecutive 10-year periods beginning in 2026.
Excluding macroeconomic feedback, CBO and JCT estimate that enacting the legislation would not increase net direct spending by more than $5 billion in either of the first two consecutive 10-year periods beginning in 2026; however, the agencies are not able to determine whether enacting the legislation would increase net direct spending by more than $5 billion in the third or fourth 10-year period.
Excluding macroeconomic feedback, CBO and JCT estimate that enacting the legislation would increase on-budget deficits by more than $5 billion in one or more of the four consecutive 10-year periods beginning in 2026.
The President is then expected to veto, setting up the need for a veto-override vote in Congress. In a statement promising Obama’s veto, the White House said the GOP measure “would take away critical benefits and health care coverage from hard-working middle-class families.”
Here in my tiny outreach maternity clinic on the west side of Orlando, we achieved in 12 months something that the U.S. health care industry has failed to accomplish in more than a quarter century. We dramatically improved birth outcomes among poor pregnant women living in central Florida, an area desperately lacking in health-care services. What’s more, all the women we cared for–including several with risk factors, such as pre-existing health problems and poverty–had healthy hospital births.
Since we didn’t prescreen or select our clients, we can only surmise that these gains, measured by a 2007 independent study of 100 clients by the Health Council of East Central Florida, were the direct result of providing consistent, quality prenatal care for pregnant women who would have otherwise faced nearly insurmountable obstacles to getting it.
Maternal mortality is a domestic human rights crisis that kills hundreds of American women and affects thousands more every year, according to Amnesty International’s new report, Deadly Delivery: The Maternal Health Care Crisis in the United States. Here in the wealthiest country in the world, two or three women die daily from complications of pregnancy or childbirth and the rate of maternal death for African-American women is four times that of white women. These grim statistics do not include more than 34,000 “near misses” –severe complications in which women nearly die–each year. Our country prides itself on pioneering medical advances and spends more than any other country on health care, yet it ranks 41st in the world in maternal mortality and 29th in infant mortality.
“Mothers are dying not because the United States can’t provide good care but because it lacks the political will to make sure good care is available to all women,” says Larry Cox, executive director of Amnesty International USA.
As a midwife working in the trenches of Florida’s poorer neighborhoods, I have witnessed firsthand the many reasons for this failure. What overwhelms me the most is the sheer number of hours my staff and I must spend performing bureaucratic triage for pregnant women trapped without health care in the purgatory of this broken system.
Most of the pregnant women who come to our clinic have been turned away elsewhere, or have already visited a local emergency room. Medicaid has instructed women to apply online. Yet to qualify for coverage, they must fax in proof of pregnancy in the form of a letter signed by a physician or a registered nurse. Private medical practices require uninsured women to pay up to $200 for a lab test or exam upfront, unless they can provide proof of Medicaid coverage. Sometimes a woman will successfully jump through all the hoops required to get Medicaid coverage, only to be turned away by doctors because by then she is 20 weeks pregnant and considered “high risk,” since she has gone through nearly half her pregnancy without prenatal care.
In many other countries health care, including maternity care, is understood as a basic human right. The unwillingness of the United States, however, to guarantee pregnant women access to quality maternity care contributes to the high number of childbirth-related deaths from common causes. Standardized protocols exist but are applied inconsistently, and too often race and economic status are factors.
As the Amnesty International report recommends, the United States can make substantive immediate gains. First and foremost, the government should establish a single office within the Department of Health and Human Services that ensures that all pregnant women have access to quality maternal care. In addition, our elected officials must support federal oversight and accountability for maternal health standards. Nothing less than the survival of hundreds of pregnant women each year is at stake.
Women should be free to make their own health decisions no matter what they earn or where they live. — by Congresswoman Barbara Lee
Conservatives and progressives don’t agree on much these days. Regardless of their party leanings, though, a clear majority of Americans believe that politicians shouldn’t meddle in a woman’s personal health care decisions.
Yet for too long, women’s health care has been a political bargaining chip.
Anti-choice politicians have worked to ensure that women enrolled in government health plans — including veterans and government employees — don’t get abortion care coverage.
That needs to stop. It’s past time to stand up and protect a woman’s access to health care, no matter how she’s insured, where she lives, or what she earns.
That’s why I introduced the Equal Access to Abortion Coverage in Health Insurance Act — or the EACH Woman Act — to ensure that politics never comes between a woman and her own personal health decisions.
Legislative tactics like the Hyde amendment, which denies many women access to the full range of available reproductive healthcare, are a constant reminder that women’s rights are under attack and that the GOP’s war on women is still raging.
These restrictions deny Medicaid coverage for abortion, forcing one in four low-income women to carry an unwanted pregnancy to term and pushing many families deeper into poverty.
In fact, according to San Francisco’s Bixby Center for Global Reproductive Health, a woman who’s denied an abortion is more likely to rely on public assistance and live in poverty, and less likely to work full time.
Meanwhile, other anti-choice legislators are taking their war on women to the states. From Alabama to Utah, they’ve passed laws that interfere with private insurers’ ability to cover abortions for policyholders. This has a profoundly negative impact on women who rely on government health care as well as those trying to buy their own.
The Hyde amendment and state laws like these force women to make choices that often aren’t best for their families, their faith, or themselves. That’s simply wrong.
The EACH Woman Act would end these outdated anti-woman policies and empower each woman to make her own health care decisions regardless of how she’s insured, how much she earns, or where she lives. Period.
However, to pass this important legislation, I need your help. We need a committed, grassroots effort of supporters calling and writing to their Members of Congress and asking them to be bold, to repeal the Hyde amendment, and to pass the EACH Woman Act.
EACH woman should able to make her own health decisions without politicians interfering.
Congresswoman Barbara Lee is a member of the House Appropriations Subcommittee on Labor, Health, Human Services, and Education. She represents California’s 13th district Congress. Lee.House.Gov
Distributed by OtherWords.org.
While Democrats have been able to prevent anti-choice language from creeping into federal law thus far, these state-based corrosive efforts are working. A ThinkProgress investigation found that the maze of state abortion restrictions, usually framed as legal regulations, is driving the price of abortion services up so high that lower-income women are effectively priced out of the market. The attack on women’s healthcare has gone so far that a Texas Republican legislator has protested her colleagues’ proposal to cut funding for cancer screenings at Planned Parenthood clinics, saying that without that “provider network, women cannot be served. And they will die.”
Free flu shots will be available at a walk-in clinic that will be set up at the West Hall of the Convention Center on Wednesday, October 29th. The clinic is being provided by the NV Division of Public and Behavioral Health (DPBH). Clinic hours for the free flu shots will be from 5 pm to 9 pm.
The Centers for Disease Control and Prevention recommend that everyone older than six months receive an annual flue vaccine. Those who are at the highest risk of developing serious complications such as pneumonia from the flu are:
People with chronic medical conditions such as asthma, diabetes, and chronic lung disease; as well as their caregivers and close contacts.
People 65 years of age and older.
For more information, call the Humboldt County Community Health Clinic at (775) 623-6575.
When the Supreme Court made the terrible decision to allow corporations like Hobby Lobby to discriminate against women, members of Congress were ready to fight back to defend women’s access to birth control.
Senators Murray, Udall and Boxer quickly introduced a bill to make sure that corporations can’t interfere with employees’ access to health care, including birth control, as provided for by the Affordable Care Act (aka Obamacare) under federal law. Senate Majority Leader Harry Reid fast-tracked the bill, bringing it for a full vote in the Senate today.
Not surprisingly, Republicans, including Nevada’s own Senator Dean Heller, used the filibuster to block an up-or-down vote on the bill, meaning it will now take 60 votes to pass this bill. Only two Republicans broke from their caucus’s en bloc action — Senators Kirk and Murkowski.
Republicans continue to use the filibuster to shut down sensible legislation, and provide cover for their members who don’t want to go on the record in opposition to things like birth control access for women, common sense gun law reform, or relief for crushing student loan debt.
This week, they used the filibuster to block a legislative remedy for the disastrous Hobby Lobby v. Burwell decision. Outrageously, the five male justices on the Supreme Court ruled that the contraception mandate violated the Religious Freedom Restoration Act. In oral arguments, Chief Justice John Roberts suggested that Congress could exempt the Affordable Care Act from the RFRA as a way of protecting the inclusion of contraception as preventative care in the ACA. The Protect Women’s Health from Corporate Interference Act does exactly that, and would have protected not only women’s access to contraception from employer discrimination, but any employees’ access to any health care provided through the Affordable Care Act.
Tell Senate Republicans to end their filibuster and allow a vote on women’s access to birth control. Click the link below to automatically sign the petition:
Vote #228 held on July 16, 2014, 02:09 PM EDT on the Motion to Proceed (Motion to Invoke Cloture on the Motion to Proceed to S.2578 )
— Roberta Lange, Nevada State Democratic Party Chair
A few weeks ago, the United States Supreme Court issued a backwards ruling that allows for-profit corporate CEOs to make medical decisions that should be made between a woman and her doctor. That’s right – in the year 2014, the Supreme Court thinks female employees’ healthcare decisions should be made in a corporate boardroom, not a doctor’s office.
This week, the United States Senate will vote on legislation to address the Supreme Court’s ruling and ensure women who work at for-profit corporations have access to reproductive healthcare. While Democrats like Senator Reid, Reps. Dina Titus and Steven Horsford, and Erin Bilbray support ensuring women have access to reproductive healthcare, Republicans like Dean Heller and Joe Heck have consistently voted to restrict women’s access to contraception.
In support of the Senate bill, Nevada Democrats are launching #ItsNotUpToThem week. All week we will be highlighting how dangerous the Republican agenda is for the health of Nevada women. Because whether it’s Mark Hutchison leading the charge to go back to a time where private insurance companies could treat being a woman as a pre-existing condition, or Joe Heck voting to weaken the Violence Against Women Act, it’s time we send a message to Nevada Republicans that women’s healthcare decisions aren’t up to them or corporate bosses.
Please note that Roberta mentioned Candidate Erin Bilbray who is running agains Rep. Joe Heck, but failed to mention Kristen Spees who is running against Rep. Mark Amodei to represent those of us who are unfortunate enough to live in NV-Congressional District 2!
‘This ruling goes out of its way to declare that discrimination against women isn’t discrimination.’
– Lauren McCauley, staff writer at Common Dreams
Defenders of women’s health and reproductive freedom are reacting with anger to the U.S. Supreme Court’s decision on Monday which ruled that an employer with religious objection can opt out of providing contraception coverage to their employees under the Affordable Care Act.
Writing for the majority side of the 5-4 decision in Burwell v. Hobby Lobby, Justice Samuel Alito argued that the “the HHS mandate demands that they engage in conduct that seriously violates [employers’] religious beliefs.”
Rights advocates were quick to condemn the court’s decision.
“Today’s decision from five male justices is a direct attack on women and our fundamental rights. This ruling goes out of its way to declare that discrimination against women isn’t discrimination,” said Ilyse Hogue, president of NARAL Pro-Choice America.
“Allowing bosses this much control over the health-care decisions of their employees is a slippery slope with no end,” Hogue continued. “Every American could potentially be affected by this far-reaching and shocking decision that allows bosses to reach beyond the boardroom and into their employees’ bedrooms. The majority claims that its ruling is limited, but that logic doesn’t hold up. Today it’s birth control; tomorrow it could be any personal medical decision, from starting a family to getting life-saving vaccinations or blood transfusions.”
Ninety-nine percent of sexually active women in the U.S. use birth control for a variety of health reasons, according to research by women’s health organizations.
“The fact of the matter is that birth control is a wildly popular and medically necessary part of women’s health care,” said Nita Chaudhary, co-founder of UltraViolet, a national women’s advocacy organization.Chaudhary adds that despite it’s clear necessity for the reproductive health of the majority of women, one in three women have struggled at some point to afford birth control.
Monday’s ruling focuses specifically on companies that are “closely-held,” which analysts report covers over 90 percent of businesses in the United States.
The dissenting opinion, penned by Justice Ruth Bader Ginsburg and supported by Justice Sonia Sotomayor and mostly joined by Justices Elena Kagan and Stephen Breyer, acknowledges that the decision was of “startling breadth” and said that it allows companies to “opt out of any law (saving only tax laws) they judge incompatible with their sincerely held religious beliefs.”
In the Court’s view, RFRA demands accommodation of a for-profit corporation’s religious beliefs no matter the impact that accommodation may have on third parties who do not share the corporation owners’ religious faith—in these cases, thousands of women employed by Hobby Lobby and Conestoga or dependents of persons those corporations employ. Persuaded that Congress enacted RFRA to serve a far less radical purpose, and mindful of the havoc the Court’s judgment can introduce, I dissent. —Justice Ruth Bader Ginsburg
The opinion was based largely on the Religious Freedom Restoration Act (RFRA), which provides that a law that burdens a person’s religious beliefs must be justified by a compelling government interest.
“There is an overriding interest, I believe, in keeping the courts ‘out of the business of evaluating the relative merits of differing religious claims,'” Ginsburg adds, concluding: “The Court, I fear, has ventured into a minefield.”
Echoing Ginsburg’s concern, Rev. Barry W. Lynn, executive director of Americans United for Separation of Church and State called the ruling “a double-edged disaster,” saying it “conjures up fake religious freedom rights for corporations while being blind to the importance of birth control to America’s working women.”
Similar reactions were expressed on Twitter following the news. Summarizing the crux of the decision, NBC producer Jamil Smith wrote:
Others, joining Ginsburg’s outrage that now “legions of women who do not hold their employers’ beliefs” would be denied essential health coverage, expressed their opinions under the banner “#jointhedissent.”
The majority opinion leaves open the possibility that the federal government can cover the cost of contraceptives for women whose employers opt out, leaving many to look to the Obama administration for their next move.
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