Tuesday, June 28, 2011

55 hours out, abortion's on tap. Again.

It really is incredible. As I write this, the Pennsylvania General Assembly is 55 hours out from its deadline to pass its annual state budget. All of the bills are lining up for passage just in time to beat the deadline on Thursday, but it has been a mad rush here at the end, especially for those legislators who predicted that the budget would be done in May.

Even in the midst of all of this, the state House is inconceivably teeing up not one but two bills to rollback women's access to reproductive healthcare. Senate Bill 3, which cuts off insurance coverage of abortion in the exchanges created by healthcare reform, and Senate Bill 732, which alters the legal requirements abortion clinics must follow, have both bounced out of committee and are headed to the House floor for a vote. Because it was amended in the House Health Committee, SB 732 would have to go to back to the Senate for a vote on "concurrence," but without an amendment, SB 3 could head to the governor after passage in the House.

If anyone needs some help understanding the dangers of SB 732, check out this news from Kansas. Abortion clinics are struggling to meet new legal requirements there:
Kansas health regulators said today that the abortion clinics they’ve inspected so far have failed to meet the requirements to get a license under a law that takes effect Friday...

The new licensing law requires clinics to be inspected twice a year, including one unannounced review. It also spells out standards for operations, supplies, facilities and medical procedures.

The regulations total 36 pages. Among other things, they require any physician performing an abortion to have clinical privileges at a hospital within 30 miles of the clinic. They also require each facility to have drugs and equipment to deal with a medical crisis such as a heart attack or an allergic reaction to medication.

They also contain a number of requirements for the building including dressing rooms for staff that are equipped with a toilet, a sink and a place to store clothes. The procedure rooms are also required to be 150 square feet and the recovery area must be at least 80 square feet per patient.

The rules also set the temperature for the recovery rooms (between 70 and 75 degrees) and the procedure room (between 68 and 73 degrees).

The regulations were sent out to providers on June 17, only days before the inspections.

Sound familiar? The situations aren't totally analogous since the Kansas requirements are different, but the strategy is the same: Alter the legal mandates in a way that creates a burden for the clinics, thus potentially cutting off women's access to a legal right.

The supporters of HB 574 and SB 732 can wrap themselves in the language of patient safety all they wish, but the reality is that this legislation is straight out of the playbook of those who believe that the government should make medical decisions for women. And that is what puts patient safety at risk.

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Friday, June 24, 2011

Reflections on last night's state House vote on voter ID

I haven't been lobbying for a long time- four years...well, 11, including my activist, pre-lobbyist days- but I haven't seen a scene quite like the one on the PA House floor last night. Chaos reigned on the House floor as members gave catcalls, shouted each other down, attempted parliamentary maneuvers to stop the bill, and warred with the Speaker of the House. The primary sponsor of the bill refused to answer questions about his own bill at least seven times. The ACLU of PA is non-partisan- fiercely non-partisan, as our legal director says- but we'll give credit where credit is due. The House Democrats fought hard against the voter suppression scheme in House Bill 934. The Protect Our Vote coalition didn't prevail, as the House passed the bill, 108-88. But we made a lot of progress. I tweeted throughout the night and a little bit this morning but want to collect some of those thoughts here.

First, six years after the last vote on voter ID, which was vetoed by then-Governor Rendell, more legislators get it. In 2005, the voter ID bill passed the state House with 135 yes votes, including 31 Democrats. In 2011, they had just 108 yes votes- seven votes shy of defeat- and zero Democrats voted yes.

I get the need for the parliamentary move to end debate on a bill. Without it, the minority can essentially filibuster a bill by talking and talking and talking until everyone is tired of it. But on this occasion, the move by the House Republicans to call to "the previous question" looked especially horrendous, for two reasons. One, many of us believe that, intended or not, the voter ID initiative is a policy that disenfranchises U.S. citizens, so it is truly ironic that the majority would suppress debate on a bill that could suppress voters.

Two, and perhaps worst of all for the House GOP, after the debate was cut off and the final vote was taken, multiple members stood up to submit their comments for the record because they did not have an opportunity to present those comments verbally. Those submitting comments included Rep. Margo Davidson, Rep. Vanessa Lowery Brown, Rep. Ron Waters, Rep. Thaddeus Kirkland, and Rep. Joe Preston.

What do these members all have in common? They are all members of the Legislative Black Caucus. With America's dark and tragic history of suppression of the black vote lingering in the background, it is particularly appalling that these members did not have an opportunity to speak.

As House Speaker Sam Smith adjourned the chamber for the night around 10:45pm, Rep. Preston was heard yelling, "This is worse than Mississippi!"

We have an uphill climb in defeating this bill. But the supporters didn't steamroll in the House, as expected. I told our allies at the start that we need to make this vote as uncomfortable as possible and see where the chips fall. We have barely begun to fight.

(Be sure to check out the interview I did immediately after the House vote on The Rick Smith Show. Rick gets it.)

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Thursday, June 23, 2011

24 hour victories

When defending civil liberties at a state legislature that is hostile to them, we have to hang our hat on all victories, no matter how small, even if they last just a few months, a few weeks, or even 24 hours.

Yesterday had the potential to be a rough day at the PA General Assembly, particularly in the House. Somehow we came out of it almost completely unscathed.

Voter ID, HB 934: We expected the House to vote on final passage. It never happened. The House adjourned abruptly just after 4pm without a vote on the bill. Also, more good news on this front yesterday. The AARP of Pennsylvania sent a letter to all House members expressing their opposition.

I still expect this bill to get a vote today or at least before the summer recess. But we'll take victories where we can get them. Rep. Mike Sturla of Lancaster had some insight on the two week delay of this bill earlier this month:
House GOP leaders delayed this bill as long as they could, but, needing budget votes from the Paranoid Delusional faction within the Republican Caucus, we now find ourselves devoting hours to debating a voter suppression bill, rather than, you know, discussing a state budget.

ID for aid, SB 9: More "papers, please" legislation. This bill denies public aid to anyone who is unable to produce government-issued ID. The House State Government Committee was expected to take up this bill but instead held it over. The bill will be part of a series of hearings the committee is going to hold over the summer on immigration issue. Mind you, without credible evidence of ineligible persons receiving benefits, it's not an immigration issue at all but is, instead, a poverty issue.

Publicly-funded private school vouchers, SB 1/HB 1708: There were some signs that a compromise on school vouchers might be jammed through before the legislature finishes the state budget, which is due June 30. On Tuesday, the House Education Committee posted notice of hearings scheduled for Wednesday and Thursday on this issue. But the Democratic chairman of the committee, Rep. James Roebuck of West Philly, objected because the notice did not follow House rules on sunshining a hearing. To his credit, the majority chairman, Rep. Paul Clymer of Bucks County, agreed and promptly cancelled both hearings.

There was some bad news...

Abortion coverage in the insurance exchanges created by healthcare reform, SB 3: We got crushed. This bill was voted out of the House Insurance Committee on a vote of 22-2. The legislature is struggling to finish the budget by the June 30 deadline (and completely missed their own goal of finishing it by the end of May) but has plenty of time to deal with abortion, apparently.

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Tuesday, June 21, 2011

"Why didn't I know that I was tested for HIV?"

Among the rush of bills being considered by the state legislature before the pending budget deadline- which is when it flows downhill, if you know what I mean- is Senate Bill 260. This bill eviscerates privacy protections that currently exist in state law on HIV testing.

Under current law, a patient must give written informed consent before being tested for HIV. In common language, that means that a patient gets information about HIV and about the test and signs off on taking the test. Sounds about right, right?

Well, a group of doctors has been pushing to get this requirement deleted from law, and that's why we're dealing with SB 260. The docs want the current requirement replaced with "documented informed consent," in which the doctor asserts that the patient consented, or opt-out testing, in which the patient must sign to get out of the test. Why do they want this? That depends upon whom you ask. They say they want more people to get tested for HIV. Everyone wants that. But there's nothing in current law that prohibits doctors from encouraging their patients to take an HIV test. If the doctors want universal testing, they should offer HIV tests to everyone and not offer tests only when they think a patient's lifestyle warrants it.

The cynics among us (me included) believe that the doctors want this portion of the law deleted because it's less work for them. Get rid of that pesky pre-test counseling and written informed consent and they can jam testing on their patients.

Some states have laws requiring pregnant women to opt out of HIV testing, and surveys indicate that some women feel pressured into taking the test. Patients who were younger, unemployed, and who did not have a regular healthcare provider were more likely to feel pressured, according to the research. And in some cases, patients did not even know that they have been tested.

Why does this matter? It matters because, unfortunately, HIV still carries a stigma. A 2009 Kaiser Family Foundation study found that 23 percent of Americans would not be comfortable with an HIV-positive roommate, 35 percent of parents would not be comfortable with an HIV-positive teacher teaching their kids, and a slim majority of 51 percent are not comfortable with an HIV-positive person doing food preparation.

It matters because an HIV diagnosis requires lifelong care. Pressuring a patient into a test or even tricking them into a test is no way to start that care.

SB 260 is bad news for patients. It opens the door to paternalistic care by doctors and disempowers patients. We've come a long way on HIV. But we still have a long way to go. Patients are better protected by current state law and not by SB 260. There's no need to mess with a good thing.


Thursday, June 16, 2011

HB 574, the Mensch amendment, & the pro-government Trojan horse

We're going to keep beating the drum over what's happening on reproductive rights at the state capitol in Harrisburg. Let me be clear, yet again: Women's access to reproductive healthcare is in serious jeopardy due to several pieces of state legislation. House Bill 574 and the amended Senate Bill 732, amended and hijacked by Senator Bob Mensch of Easton, would alter the legal playing field for abortion clinics in ways that would be so onerous that clinics would have to spend hundreds of thousands, maybe over a million, dollars to comply.

Supporters of HB 574 and the Mensch amendment, including the Pennsylvania Catholic Conference and the Pennsylvania Family Institute, have wrapped themselves in the language of women's safety, as if we're all supposed to believe that suddenly they want women to have safe access to abortion care. Try wrapping your head around that one.

But yesterday the Pennsylvania Catholic Conference showed their true colors in an email sent to their listserv. The Conference made clear their true reasons for supporting the legislation and implied that they support the legislation because it will, indeed, cut off access to abortion care:
Today, the Senate voted 38 to 12 to pass Senate Bill 732, which, thanks to the Mensch Amendment added on Wednesday, June 8, would hold abortion facilities to the same fire and safety standards, personnel and equipment requirements, and quality assurance procedures as other freestanding ambulatory surgical facilities. The Mensch Amendment was a courageous stand for the pro-life cause. (emphasis added)

"A courageous stand for the pro-life," i.e. pro-government, "cause"? Need I say more? Only the American Family Association of Pennsylvania- the crazy Uncle Charlie of the pro-government, anti-gay crowd in PA- has been honest enough to admit that they're supporting the bills because they could close clinics. Diane Gramley of AFA of PA sent an email to their listserv on May 9 that said:
The passage of such legislation would significantly reduce the number of abortions, abortion facilities and abortionists in Pennsylvania.

The pro-government advocates can try to hide behind the language of "safety," but their motivations are obvious.

(Aside: I've been struggling with what framing to use to describe those who want women to have no access to reproductive healthcare. I'm not a fan of "pro-life" or "anti-choice." I've settled on "pro-government" for the moment because these are people who believe that the government should make private medical decisions for women. If you have any other ideas, let me know.)

Update, 12:50pm: The Lancaster Intelligencer Journal has called out the supporters of HB 574 and the amended SB 732 for the same reason.
Forcing clinics to enlarge room sizes, which already are covered by building codes, or replace existing elevators with hospital-grade elevators has nothing to do with protecting a woman's health.

Pennsylvania has strict abortion laws. That's as it should be.

But the Gosnell situation is being exploited to make it even more difficult for women in the state to obtain an abortion.

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Wednesday, June 15, 2011

Greetings from Harrisburg! The ongoing abortion saga

The state Senate passed the amended Senate Bill 732, requiring abortion clinics to follow the ambulatory surgical facilities regulations. Plus, Senate committees moved bills on prison reform and blocking the implementation of Real ID. Learn more with this update, and check out our legislative webpage.

Please note that by playing this clip YouTube and Google will place a long-term cookie on your computer. Please see YouTube's privacy statement on their website and Google's privacy statement on theirs to learn more. To view the ACLU of PA's privacy statement, click here.

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Wednesday, June 08, 2011

Greetings from Harrisburg! Reproductive rights in crisis in PA

The state Senate passed an amendment today (June 8) to require freestanding abortion clinics to follow the same regulations as ambulatory surgical facilities. Learn more about this and the latest on an attempt to require all voters at every election to show photo ID.

Please note that by playing this clip YouTube and Google will place a long-term cookie on your computer. Please see YouTube's privacy statement on their website and Google's privacy statement on theirs to learn more. To view the ACLU of PA's privacy statement, click here.

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Monday, June 06, 2011

Protection by prosecution?

On Friday, the Pittsburgh Post Gazette published a letter to the editor co-signed by the Juvenile Law Center, the PA Psychiatric Society, and the ACLU of PA. The letter asks a basic question: How does prosecuting kids for sexting protect them? Protection by prosecution?

Here's the letter:
Educate teens

House Bill 815, which proposes to make any teen sexting a criminal offense, was passed by the state House of Representatives on May 23. HB 815 is being promoted as a measure to protect teens from possible exploitation -- through arrest, humiliation and saddling children with criminal records. Protection through prosecution?

This bill would make it possible for district attorneys to prosecute any teen who sends or receives any nude or partially nude photo -- even when a photo has only been shared consensually between two individuals.

Lawmakers should rightfully worry about protecting children from individuals who intend to harm by disseminating photos without consent or those who try to coerce others into taking and sending photos, including sexual predators or bullies -- something Sen. Stewart Greenleaf's SB 850 addresses more appropriately.

HB 815 fails to make the important distinction between consensual activity and cyberbullying -- two very different actions. It drags teens into the criminal justice system even when there are no victims, and creates a barrier to reporting abuse. If HB 815 passes, even the victim can be prosecuted. Kids who are coerced into sending photos are less likely to report the crime when they themselves may be prosecuted.

Teenagers make foolish mistakes. Does that make them criminals? We need to educate teens about the dangers of risky behaviors like sexting, not prosecute them. Criminalizing consensual sexting does the exact opposite of what it was intended to do. It creates victims. Let's focus on protecting children from predators, not district attorneys.

Deputy Director and Chief Counsel
Juvenile Law Center

Executive Director
Pennsylvania Psychiatric Society

The letter also was signed by Andy Hoover, legislative director, American Civil Liberties Union of Pennsylvania.

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Sunday, June 05, 2011

This week at the state capitol: Voter ID, Abortion, HIV, Oh, my!

Another week of session at the state capitol is upon us. And the attempts to erode your rights continue.

We expect House Bill 934, Rep. Daryl Metcalfe's voter ID bill, to get a vote in the state House this week. The bill would require all voters at every election to show unexpired, government-issued photo ID, effectively disenfranchising a large swath of U.S. citizens who do not have such ID. Supporters are chasing the ghosts of voter fraud while providing no credible evidence of fraud. And my personal favorite, they equate voting with driving a car, getting a library card, and renting a movie at your local Blockbuster store (if you still have one). So the cornerstone of our democratic experiment, the vote, is equal to your ability to go down the street and pick up a copy of Fast Times at Ridgemont High. Gnarly.

The New York Times published a story on this vast right wing conspiracy last week.

On the Senate calendar, two abortion bills, SB 732 and SB 3, continue to linger menacingly, and there's a good chance that the Senate takes up one or both of these bills this week. SB 732 beefs up the inspection process for abortion clinics. While there are some minor problems with that bill, the real issue is with an amendment by Senator Mensch of Easton that alters the legal requirements for clinics in such a way that the clinics would have to spends hundreds of thousands and maybe more than a million dollars in building renovations and staff increases.

SB 3, meanwhile, prohibits insurance companies from offering coverage of abortion care when they participate in the insurance exchanges, or marketplaces, created by federal healthcare reform. That includes policies that are purchased with private money. Sounds like a government takeover of healthcare....

Finally, on Tuesday, the House Human Services Committee is scheduled to consider Senate Bill 260. This bill erodes the privacy protections currently in state law on HIV testing. It replaces a requirement of written informed consent with "documented" informed consent, meaning the doctor could sign off on the test instead of the patient; allows doctors to force patients to opt out of an HIV test, rather signing into the test; and eliminates the requirement in law for pre-test counseling. The ACLU of PA opposes this bill for privacy reasons. Unfortunately, HIV still carries a stigma that can lead to discrimination, and it is important that patients not feel forced into a test. I'm also not clear on why withholding information from patients is a good thing, and the supporters of this bill have yet to respond to that point.

As always, you can find more details about our positions on these and other bills at our legislative webpage.

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