The anti-choice myth that community health centers could easily fill in for Planned Parenthood if the reproductive health-care provider loses federal funding has become pervasive among conservatives hoping to justify defunding the organization. It’s a claim that has been repeated by anti-choice organizations and politicians alike—and when it goes unchecked, it stands to perpetuate a falsehood that could have harmful consequences. Should the federal government strip reproductive health-care clinics from its funding programs, it will be devastating for millions of people who rely on such providers, not always just for reproductive care.

The claim appeared again last week in an advertisement in Politico’s widely read Huddle tipsheet, which offers a “play-by-play preview of the day’s congressional news.” Among the tipsheet’s sponsored headlines were multiple ads from the anti-choice Susan B. Anthony List featuring misinformation and cherry-picked data about Planned Parenthood.

The text ads contained a link directing readers to a landing page on the group’s website repeating the aforementioned misinformation about reproductive health care. But the ad glosses over the truth.

“Congress will soon consider re-directing taxpayer funding away from Planned Parenthood and to community health centers, which outnumber Planned Parenthood 20:1 nationwide,” claimed the first entry. “These centers provide comprehensive health care for women but do not perform abortions or harvest fetal body parts. Polling shows the majority of Americans support this effort.”

As the Washington Post explained when fact-checking an almost identical claim by House Speaker Paul Ryan during a CNN town hall event in January, the statistic in question originates from the anti-choice Charlotte Lozier Institute, the research offshoot of the Susan B. Anthony List. The group claims that “there are 20 community health clinics for every Planned Parenthood.”

But as the Post’s Michelle Ye Hee Lee wrote, while the numbers themselves may be close to accurate, Ryan’s claim “is based on assumptions that are too uncertain, and lack context”:

Ryan is referring to federally qualified health centers and rural health clinics, which are both outpatient primary care health providers for underserved populations. He is correct that these centers, combined, are vastly bigger in network than Planned Parenthood and “provide these kinds of services” that Planned Parenthood does (i.e., cancer screening, STD/STI screening and treatment, contraceptive services, pregnancy tests and prenatal services).

But a key caveat is that rural health clinics — which account for about a third of the network that Ryan is referring to — are not required to provide family planning services and do not have to serve low-income patients. And federally qualified health centers provide a broader range of services and fewer contraceptive services than Planned Parenthood does. The Congressional Budget Office has warned there would be an immediate disruption of services if Congress pulls Medicaid money from Planned Parenthood and instead increases funding to federally qualified health centers.

As Rewire reported at the time of Ryan’s comments, while community health centers are a vital part of the United States’ health-care system, experts say they could not fill the gap in coverage that would occur should Republicans defund Planned Parenthood. Like Ryan, the ad from Susan B. Anthony List did not mention that the federal dollars received by the reproductive health provider—and any other provider that offers abortion care—are already blocked from paying for abortion care thanks to the Hyde Amendment.

Putting aside the clear reference to the discredited and deceptively edited videos released by the Center for Medical Progress, the ad also cherry-picks polling data to falsely claim the public supports pulling taxpayer funding for Planned Parenthood.

Susan B. Anthony List’s landing page cites a single December 2015 poll from the Robert Morris University Polling Institute as evidence, but even the press release linked by the organization says, “Previous polling on the issue of funding Planned Parenthood has shown majority support for government funding of Planned Parenthood.” The poll’s authors attribute the difference to their narrowly worded question that specifically asked:

Congressional Republicans favor shifting Planned Parenthood federal funds to community clinics that perform the same services, but do not perform abortions. Would you say you support or oppose this plan?

The vast majority of other polling—including a poll recently reported on by Politico and another conducted last year by the news site itself—has indeed found that the public does not support cutting the organization off from federal funding.

Politico‘s advertising department did not respond to multiple requests for comment from Rewire about whether the outlet required their advertisements to be factual, or if these particular anti-choice ads were vetted. However, the false claim that community health centers could fill Planned Parenthood’s shoes has also appeared in several news stories from the outlet.

An August 2015 piece from Politico did note that Planned Parenthood says community clinics couldn’t absorb all of their patients should it be defunded, but presented the fact alongside a quote from a member of the GOP who disagreed and provided similarly misleading claims about the centers outnumbering Planned Parenthood clinics. A November 2016 article from the outlet reported that “Republicans say they will redirect the funding that would have gone to Planned Parenthood to community health centers,” but failed to address the implications of such a move.

In other pieces, variations of the claim were mentioned without addressing whether it was true.

Despite being roundly debunked, the assertion that community health centers could fill in for the absence of Planned Parenthood has nonetheless continued to go unchallenged in the media far beyond Politico. The falsehood is especially rampant with conservative media figures on networks like Fox News, but it has also gone unchecked in some mainstream media outlets.

For example, in the aforementioned town hall with Speaker Ryan, CNN’s Jake Tapper pushed back on the Republican’s blatantly false suggestion that taxpayer funding went to abortion care but didn’t follow up when Ryan asserted that community health centers could replace Planned Parenthood.

Speaking generally about misinformation on these topics in the media, Sharon Kann, reproductive rights program director at the media watchdog Media Matters for America, told Rewire last Tuesday by email that “allowing false statements about reproductive health to spread unchecked is incredibly dangerous, and often contributes to support for anti-choice legislation with wide-reaching, negative effects.”

When it comes to the myth that community health centers could fill in for Planned Parenthood, Kann noted that “media [outlets] have a responsibility to address the underlying argument when presenting quotes from politicians about health care access.”

“The idea that community health centers can seamlessly replace Planned Parenthood isn’t a new piece of misinformation, but it’s one that’s had staying power in part because media outlets tend to either accept the premise as true, or uncritically repeat the claim without context,” she said. “The reality—and we’ve seen this play out in multiple states that have attempted to replace Planned Parenthood—is that not all community health clinics are equipped to provide reproductive health care, or even a full set of preventative care services.”

Allowing the claims to go unchecked isn’t the only way the media allows for the perpetuation of this falsehood. “In many cases, despite the score of experts and studies refuting the 20:1 claim, media will try to report what seems like ‘both sides’—an approach that often means claims that originated with anti-choice groups and outlets are given equal weight as comments from health care experts or actual providers,” said Kann.

A feature published by CQ Magazine last week fell into this trap, allowing Ryan’s falsehoods on community health centers to go largely unchecked and instead offering a false equivalency between the anti-choice conservative and the reproductive health experts who are supported by the evidence.

“Ryan argues that the money Planned Parenthood receives … could be better put to use by community health care clinics,” the article said. Only later did it note that “Planned Parenthood and its advocates have raised concerns about whether community health centers will be able to absorb the Medicaid patients who now go to Planned Parenthood.”

That research and experts support the inability of community health centers to fill this gap goes entirely unmentioned.

According to Kann, media can better address falsehoods by asking “specific questions about precisely which providers will replace Planned Parenthood and who will be able to access their services.”

“Not all community health centers are equipped to provide reproductive health care,” Kann noted. “Media [outlets] ought to be investigating this and calling out attempts to mislead the public by conflating the total number of community health centers with the much smaller subset that actually provide the same services as Planned Parenthood.” 

“More broadly, good media coverage of reproductive health and rights should uplift the voices and experiences of those who are impacted by these policy decisions,” she added. “The narratives and experiences of people who have had abortions or who no longer can access basic care when Planned Parenthood clinics close are an essential perspective that is often left out of reporting …. Media should be making clear to readers that there’s a cost to policymaking that’s based on misinformation—and it’s often the well-being of those who are often already marginalized.”

Source: https://rewire.news/article/2017/02/21/media-challenge-anti-choice-falsehoods-planned-parenthood/

Thanksgiving is over, but the holiday season is notorious for uncomfortable conversations about politics, sexuality, and reproductive rights. While respectful political debates between friends and family members were often hard to come by before the Trump administration took office, the ever-increasing prevalence of alternative facts and politicized misinformation can make genuinely productive discussions nearly impossible. For many of us, these are uncharted waters.

But advocates for reproductive rights and justice have been battling fake news for decades and are key experts in navigating troubled waters.

Rewire spoke to nearly a dozen health-care practitioners, reproductive justice activists, and sexuality educators about their strategies for encouraging open dialogue about potentially polarizing topics. Their knowledge and experience can help laypeople initiate or take part in fruitful conversations about sexuality, contraception, and abortion—or talk over controversial issues beyond reproductive health.

Here are some of their time-tested tricks and tips, which can be deployed during almost any difficult discussion.

Set the Tone

If you suspect that a specific issue is likely to spark conflict, be clear about how you want to approach it. Create comfortable parameters at the outset of your talk by deciding which topics are off-limits, or by crafting an informal community agreement before embarking on an especially challenging conversation.

According to Boston-based sex educator and therapist Aida Manduley, normalizing not knowing something is a crucial step toward establishing a nonthreatening environment and fostering mutual understanding. They suggested correcting misconceptions with simple phrases such as “A lot of people actually don’t know this, but…”  or “I just learned this recently.” It’s a technique Manduley frequently employs while leading training workshops on transgender health care for medical providers.

“People don’t like to feel dumb. People don’t like to feel like they are at a loss, especially if they’re in a position of power,” Manduley explained. “If someone already has a lot of cultural cache or social standing, it can be hard to listen.”

Be Prepared to Meet People Where They Are

Chanel Jaali Marshall—a Washington, D.C.-based HIV and AIDs activist and founder of the Jaali Company adult sexuality education group—believes that being open-minded and prepared to meet people on their level can start off a tough conversation on the right foot.

“You have to consider people’s culture, you have to consider religious factors, you have to consider all these things,” she said. “Just be aware that everyone is not the same.”

Julie Metzger, a registered nurse who lectures on puberty and human sexuality to preteens and their families with her Seattle-based company Great Conversations, emphasized the importance of tailoring your remarks to your audience. And that includes taking age and knowledge into account. An 18-year-old won’t process information the same way as a 40-year-old.

“When you honor the developmental states of the audience, you gain their trust by keeping it safe,” she said. “That is a powerful and important thing to do.”

New Orleans-based sexuality educator and founder of the Women of Color Sexual Health Network (WOCSHN) Bianca Laureano avoids unnecessary miscommunication by assessing her students’ level of media literacy. She often invites people to explain how they seek out information and attempt to confirm the veracity of their facts.

“A lot of people don’t know what it means to go to the Library of Congress website and get a citation,” she said. Asking people to back up their beliefs and vouch for their sources raises awareness that all websites or facts aren’t the same or to be trusted equally.

Acknowledge Emotion

“You can’t talk to people about feelings with facts,” said Amy Hagstrom Miller, the president and chief executive of Whole Woman’s Health, which was the lead plaintiff in Whole Woman’s Health v. Hellerstedt, the landmark 2016 U.S. Supreme Court case that struck down two provisions in a Texas law regulating abortion providers.

“I’ve found that people are sometimes more open to hearing the actual data and the facts if the conflict and the feelings part is acknowledged in the process,” Hagstrom Miller explained, adding that she’s usually able to stop emotions from hijacking a talk by briefly mentioning the potential for strong feelings to hinder constructive conversations.

Address Stigma Upfront

St. Louis-based sex educator, reproductive rights advocate, and sex shop manager Cicely Paine cautions ambitious communicators to remember that the specter of social stigma frequently haunts discussions of taboo subjects like human sexuality and pleasure.

She said that reframing issues related to sex and sexuality around health care and self-care can often dispel shame and allow for more productive conversations. Her favored tactic with nervous customers at her adult gift shop involves “just being super intentional about it.”

“They know that they want something that’s in there, but there’s so much internalized stuff, that they don’t even know what to say or how to say it,” she said.

Paine makes sure to let customers know that she’s open to hearing what they’re thinking and feeling, and often explicitly tells them that they’re going to get through this together.

Find Common Ground

In her former work as a sexuality education specialist at Planned Parenthood of the St. Louis Region and Southwest Missouri, Paine learned to look for overlapping values and goals while speaking with parents of teenagers.

“Their values around teen sexuality [are often] ‘I don’t want my kid to have sex,’” Paine explained, adding that she was frequently able to reframe conversations with hesitant parents by searching for common ground and identifying shared aims.

As she often put it to uneasy parents, “We want your kid to be safe and healthy, so what ways can we both work around that idea, even though we might have different values and perspectives in how we see what health and safety looks like for young people?”

Share Quality Information

Hagstrom Miller of Whole Woman’s Health said access to accurate, nonpartisan information goes a long way toward building bridges.

“I think people have learned to be very skeptical of both the anti-abortion movement and the pro-choice movement because they always feel like someone’s trying to lobby them,” Hagstrom Miller said.

She’s found that even a simple, straightforward timeline of recent restrictions to abortion access has the capacity to astonish audiences.

Know That Identity and Bias Affect Listening

Remembering that society often undervalues the knowledge and experiences of marginalized communities and women is also key, Hagstrom Miller explained, adding that abortion opponents often exploit this unfortunate reality to inhibit reproductive choice.

“I think that we have just such a fundamental disrespect and skepticism of women’s knowledge and authority and abilities in our country. It’s just ingrained in us as humans, even those of us who are feminists, I think sometimes, if we really examine our behavior,” she said.

Use Humor

Comedian and co-founder of Lady Parts Justice League Lizz Winstead believes humor can open up conversations and break down barriers by pushing the envelope in terms of what constitutes acceptable topics of conversation. That’s the philosophy that guides her comedy group, which has drawn attention to fake abortion clinics and helped destigmatize emergency contraception through their sharply funny YouTube videos.

Winstead said she’s also learned to use comedy to move audiences to action instead of simply stoking their anger. She designed a recent Lady Parts Justice League live comedy tour to direct volunteers to organizations that need their help.

“Oftentimes, the humor can get people in the tent, get them excited, get them educated, and then the actual conversation needs to happen with them about what are we going to do now,” Winstead said.

Push Back

Listen carefully to opposing points of view, but don’t be a doormat, the experts warned. Ask your loved ones to explain their thinking and speak up if facts or statistics seem suspicious. Point out logical inconsistencies, and don’t let misleading comments slide.

Connecticut-based sexologist, educator, and Widener University doctoral candidate Cindy Lee Alves suggested pushing back against lazy stereotypes and unfounded generalizations about marginalized populations by centering the oppressed, while pushing socially privileged people to speak from their own observations.

“I try to get people to be able to voice what they want to voice, but have it come from a place of their experience,” she said.

Be Mindful of Body Language

Dr. Barbara Levy, who serves as the vice president of health policy for the American Congress of Obstetricians and Gynecologists, recommended using your body language and eye contact to communicate an atmosphere of openness and equality.

“In order to read my patient, I’ve got to be looking at her. I have to be looking at her face and interpreting her body language,” Dr. Levy said. The same goes for friends and family members.

Dr. Sandra Carson, ACOG’s vice president of education, witnessed the importance of body language firsthand as a professor at Brown University, where she started an improvisational acting class for medical students. A local theater group taught future doctors nonverbal communication through pantomiming exercises.

“The lesson that we took home from that was when you’re communicating with patients, you want to open up when topics come up that are open and close your body language when it’s a very serious topic to stress the importance, and the patient will mimic those actions if she’s understanding you,” Dr. Carson said.

Take a Break

WOCSHN’s Laureano noted that if she’s speaking to someone who’s becoming visibly upset, she frequently pauses the conversation. She’ll ask if they’re open to taking a breath together to reset the moment and keep the conversation going.

“I also think about safety, not just for myself, but for everyone else in the space,” Laureano said.

Create a Habit of Inclusivity

Don’t throw sex workers or marginalized communities under the bus by relying on arguments that run contrary to your values, the experts cautioned. Comedian Winstead warns against using stigmatizing language or ideas to make short-term gains with people who disagree with your politics, citing the pervasive tendency to demonize abortion, even among pro-choice advocates.

“We’ve allowed so many tropes to come from the right, and we’ve allowed their language to be the language and a lot of that is really shaming,” she said.

Alves, the Connecticut-based sexologist, recommended taking a proactive approach by creating a habit of inclusivity with your words, even if you don’t think it’ll matter to anyone in the room. Alves says that’s why she insists on asking all of her students to share their pronouns.

“I want to honor how you want to be addressed, and I’m not going to assume your gender based on what I’m looking at,” Alves said. Even when she’s talking to people who aren’t aware of using gender-inclusive language, she does so anyway and uses the opportunity to “bring up the fact that [being unaware] is a privilege.”

Never Stop Learning

Resist the temptation to rest on your laurels. Keep learning and challenging yourself to communicate more effectively, said Great Conversations’ Metzger. She’s currently updating her course’s approach to discussing gender identity after decades of groundbreaking educational work with preteens and their families.

“We learn all the time from the people who come, so we’ve been really challenged and excited,” Metzger said. “It’s about honing your language” and seeing every conversation as an opportunity to grow.

https://rewire.news/article/2017/11/29/woods-tips-difficult-conversations/

In 1982, the small, low-income rural health clinic operated by Eula Hall from her home in Mud Creek, Kentucky, burned to the ground. After taking the morning off to assess the damage, likely caused by a frustrated intruder attempting to loot the pharmacy, she re-opened the clinic, such that it was, from a picnic table pulled under the shade of a tree where she coordinated appointments from a telephone line hastily installed on its trunk.

This memory of Eula served me well during 2017 and I thought about her often—a determined woman who, like me, became stuck and then worked to free herself and others from the wreckage of a clumsy thief who would rather burn things down than admit his plans a failure.

The national perception of Appalachia in 2017 made little room for people like Eula Hall, who today is 90 years old and is still the patron of her low-income clinic. Rather, many came to know Appalachia through a glut of character studies obsessed with the inner lives of white, disaffected Trump voters in which progressive, justice-seeking voices became as rare as employed coal miners. Entire population groups that complicated the idea of Appalachia as the natural dominion of resentful, white, working-class men and their families ceased to exist.

This monolithic place is not the Appalachia I know. As I wrote in my forthcoming book, the Appalachia I live in is one where the region’s problems are set against a long history of organizers who “have struggled against them, often sacrificing their health, comfort, and even their lives.” With a similar intent, let me give you a snapshot of the Appalachia you didn’t often see in the press this year—the Appalachia filled with activists and organizers seeking many forms of justice, from reproductive rights to environmental protections, often using principles of community organizing passed down through generations to mitigate the harm promised to the region’s most vulnerable residents.

The potential for harm is great. According to many metrics, Appalachia is ground zero for rising health-care costs and access disparities, which have profound consequences on reproductive and sexual health in the region and, when combined with reactive politics, literally hold bodies hostage in a war over values. Political leaders in Kentucky and West Virginia, on both sides of the aisle, are particularly hostile to reproductive freedom, orchestrating the closure of all but one abortion-providing clinic in both states this year.

Caring for the reproductive and sexual health needs of rural and low-income people and all people of color in Appalachia often falls to clinics like the Women’s Health Center, in Charleston, West Virginia, and the EMW Women’s Surgical Center, in Louisville, Kentucky, both facing ongoing and pivotal legal battles this year as pressure to effectively ban abortion in these states intensifies. The new year in Kentucky started, for example, with a ceremonial signing of historic anti-abortion legislation by Republican Gov. Matt Bevin, who told the press, “We must continue to fight this scourge that is the taking of innocent life.”

In Appalachia, the movement for reproductive justice that has risen to the challenge of combating abortion restrictions is multi-racial, multi-generational, and multi-faith. Its leaders are people like the the Rev. Millie Peters, who formed the Kentucky chapter of Concerned Clergy for Choice in 2014 and Caitlin Hays Gaffin, the director of operations at WV Free, a reproductive rights organization based in Charleston, West Virginia. Other grassroots organizations that fill gaps in reproductive care and education have formed or expanded. The Kentucky Health Justice Network recently launched the All Access EKY program, directed by Whitesburg, Kentucky, native Stacie Sexton, to promote birth control access in underserved counties. In a recent interview with CNN, Sexton said, “Our goal is helping people control their futures.”

The opioid epidemic in Appalachia also occupies an urgent place in regional public health concerns. Although the Trump administration has recently announced plans to focus policy on combating the crisis, including expanding the enforcement powers of the Drug Enforcement Agency in Appalachia, much of the day-to-day care and management of those experiencing addiction falls to organizations in the hardest-hit communities. In southeastern Ohio, Bassett House is one of the only treatment centers for children and teens and now operates on a shoestring budget due to funding cuts enacted under the Ohio’s Behavioral Health Redesign program that caps Medicaid payments at a lower rate.

Because of the dearth in drug-treatment funding in Appalachia, grassroots organizations often focus on prevention, harm reduction, and compassionate programs that offer emotional support and outlets to those impacted. In April, the Pittsburgh-based Saltworks Theatre Company premiered “Off Script,” a play performed by teens based on the experiences of individuals who had battled addiction. The Higher Ground Theater, in Harlan County, Kentucky, offers similar programming through participatory action theater, starting with their 2005 namesake production that focused on prescription drug abuse.

In November of this year, officials in North Carolina launched the state’s first needle exchange program run by a county fire department, using kits donated by the North Carolina Harm Reduction Coalition. According to the organization, “harm reduction refers to a range of public health policies designed to reduce the harmful consequences associated with drug abuse, sex work, and other high-risk activities.” Support for harm reduction strategies has risen in Appalachia as the opioid crisis has worsened.

Environmental activism in Appalachia is a public health matter as well, but also a reminder that environmental justice is always racial justice. In West Virginia, Virginia, and North Carolina, affected residents and their allies have waged a determined fight this year against two proposed natural gas pipelines planned for immediate construction. The developers of the Atlantic Coast Pipeline plan to use experimental compressor stations in two communities in Virginia and North Carolina that are home to a significant population of low-income African-Americans and Native individuals respectively. In response to this threat, a coalition of groups across three states organized a people’s tribunal in Virginia in October, placing modern resource extraction and its consequences within the long history of settler colonialist plunder.

In December, grassroots environmental organization Appalachian Voices joined the North Carolina NAACP to sue Duke Energy to obtain an order requiring the energy company to remove coal ash from the groundwater in Stokes County, North Carolina. NAACP North Carolina President the Rev. T. Anthony Spearman told the Greensboro News & Record, “This is a quintessential example of environmental justice. In a county that’s predominately white, Duke Energy’s polluting coal ash sits in the middle of a Black community with limited means.”

In West Virginia, opposing a proposed Appalachian gas storage hub—a vast network of underground storage and pipelines for natural gas—is a focus of the Ohio Valley Environmental Coalition. Trump’s November $83.7 billion memorandum of understanding with China Energy Investment Corp. to create chemical and gas projects in West Virginia brought the hub one step closer to reality. Set against this enormous sum are people like the late Dianne Bady, the founder of the Ohio Valley Environmental Coalition, who passed away this year, who believe “The only way you can win on environmental issues is if the power of organized people is greater than the power of organized money.”

This brief slice of Appalachian activism has been about the year that was—but it is also about the year ahead and the battles to come. Instead of telling people in red states or Trump Country to “just move to a blue state,” a more productive strategy in 2018 might be to support, acknowledge, and learn from the work of Appalachian organizers engaged in local fights that the Trump administration promises will soon be national.

Source: https://rewire.news/article/2017/12/21/unseen-unsung-appalachia-fighting-future/

Congressional Republicans punted into early 2018 what could have been a dramatic year-end government shutdown over an abortion crisis of their own making: whether to add the Hyde Amendment to a bipartisan U.S. Senate plan temporarily stabilizing the Affordable Care Act (ACA), or Obamacare.

As the longstanding appropriations ban on federal funding for abortion except in rare circumstances, implemented annually since 1976, the Hyde Amendment already applies to Obamacare’s embattled cost-sharing reductions (CSRs) that reduce the price of insurance for people with low incomes. Even Senate Health, Education, Labor, and Pensions (HELP) Committee Chair Lamar Alexander (R-TN), who opposes abortion, doesn’t think his bill needs to spell out the Hyde Amendment because of who’s in the White House.

“This is only a two-year law so [President] Trump-[Vice President Mike] Pence will be there the entire time of the existence of this law, which I would think would cause pro-life groups—and I have a 100 percent pro-life rating—to be comfortable with it,” Alexander told Politico’s Pulse health-care policy newsletter.

Anti-choice groups disagreed. The Susan B. Anthony (SBA) List falsely claimed in a press release that a vote for Alexander’s bill, which he co-wrote with the HELP Committee’s top Democrat, reproductive rights champion Sen. Patty Murray (WA), “is a vote for taxpayer-funded abortion.” SBA List on Tuesday led a coalition of 67 anti-choice groups in warning members of Congress that they would oppose not only the underlying bill, but also “any larger legislative package that includes stabilization funds for abortion-covering plans.”

Should the Hyde-esque provisions not be added to the Senate’s Alexander-Murray bill, a number of influential Republicans in the U.S. House of Representatives threatened to withhold support from a must-pass continuing resolution to keep the government funded and running beyond December 22—this coming Friday. They raised objections during a Tuesday morning meeting of the House GOP conference, according to The Hill, and House Speaker Paul Ryan (R-WI) backed them up. By Wednesday, House and Senate Republican leaders, facing opposition from multiple constituencies within their conferences, decided to pursue a straight continuing resolution with no extraneous provisions.

The dissenting Republicans, in all likelihood, want more than a simple reiteration of existing Hyde policy, perhaps best known for barring Medicaid beneficiaries from obtaining abortion services through their government-run health care. House Republicans could insist on cutting off CSR payments to any and all health-care plans that cover abortion, even if those plans are in the private insurance market. The fact that CSRs can’t and don’t fund abortion itself, in accordance with federal law, doesn’t square with the GOP myth that taxpayer money is fungible. Republicans have long used that myth to attack Planned Parenthood, and now they could wield it to create a chilling effect that leads private insurers to drop abortion coverage.

House and Senate Republicans tried to finagle a comparable outcome earlier this year. They sought to end abortion coverage in any health insurance plan, public or private, through their ultimately doomed Obamacare repeal bills. The House-passed bill, for instance, delivered a one-two punch, ending CSRs and prohibiting federal tax credits from insurance plans that cover abortion, according to a Kaiser Family Foundation brief. But the restrictions, along with a provision to defund Planned Parenthood, violated Senate rules and couldn’t have proceeded as was even if the repeal bills had been successful.

Such precedent doesn’t bode well, according to a reproductive rights advocate based in Washington, D.C. “If past is prologue, we know that’s going to be really bad,” the advocate said. “They’re going to go for the worst thing.”

A different reproductive rights advocate elaborated on the consequences of denying CSR payments to insurers that cover abortion: “Insurers will have to decide to include abortion coverage or forgo billions of dollars,” the second advocate said. “So, it would basically coerce insurance plans to drop private coverage of abortion.”

House Pro-Choice Caucus Co-Chairs Reps. Diana DeGette (CO) and Louise Slaughter (NY), both Democrats, expressed similar concerns.

“This Republican-produced instability has created a dire need for CSR funding among health insurers,” they said in a joint statement on Wednesday. “By attaching abortion-coverage restrictions to CSR funds, dramatic declines in abortion coverage are likely to occur across the country, denying many women access to safe and affordable care.”

The Background

Without CSRs, Vox‘s Dylan Scott explained, people with low incomes will still qualify for Obamacare’s financial assistance. “The most immediate questions will be: Can insurers hike their rates even more to account for the loss of CSR payments, or can they drop out of the Obamacare markets entirely?” he wrote.

Alexander and Murray in mid-October thus struck a bipartisan deal to continue the payments and provide certainty for insurance companies. Their plan followed Trump’s decision to stop CSR payments in keeping with the administration’s regulatory and executive actions to undermine Obamacare in the absence of a legislative repeal. (In a twist, the White House now reportedly supports the legislative fix for CSRs.)

Then came the GOP’s regressive tax overhaul, currently en route to Trump for his signature into law. The tax bill repeals Obamacare’s individual mandate, the foundational requirement for people to purchase health insurance or face a penalty, despite the nonpartisan Congressional Budget Office’s estimate that the move will drive 13 million more people off insurance over the next decade. Sen. Susan Collins, a more moderate Maine Republican who helped sink her party’s Obamacare repeal efforts, agreed to vote for the tax bill if Senate Majority Leader Mitch McConnell (R-KY) promised to pass the restoration of CSRs, among other demands.

Collins’ vote doesn’t represent a fair trade, according to Democrats.

“The Alexander-Murray bill was never designed to fix the problem that [Republicans are] creating with this tax bill,” Murray told reporters on Tuesday following Senate Democrats’ weekly policy lunches.

The Stakes

Now, Republicans want to add a measure curtailing reproductive rights to an already ineffective health-care fix.

Democrats aren’t having it.

“A good faith effort would not be laying down a marker that it must have the Hyde Amendment in it,” Senate Minority Leader Chuck Schumer (D-NY) said during the same Tuesday press conference. “That’ll kill it altogether.”

As Republicans increasingly realized that extraneous provisions would doom the continuing resolution, Alexander and Collins issued a joint statement on Wednesday announcing that they had asked McConnell to refrain from including the CSR plan in the continuing resolution.

“It has become clear that Congress will only be able to pass another short-term extension [of government funding] to prevent a government shutdown and to continue a few essential programs,” Alexander and Collins wrote. Their assessment was correct; Republicans have dropped full fiscal year 2018 defense spending, a GOP favorite, from the continuing resolution.

But Alexander and Collins are just punting the CSR issue to the new year. Congress must pass a continuing resolution by Friday in order to avert a government shutdown. The version under consideration would keep the government running through January 19, at which time Congress will either have to fund the government through another short-term continuing resolution or an omnibus spending package to fund the government through the September 30 end of the current fiscal year.

Two spokespeople for Collins did not respond to Rewire’s emails requesting the senator’s position on the abortion restrictions. Collins has a mixed record on reproductive rights.

Collins’ GOP colleagues haven’t shied away from government funding fights over reproductive rights in recent years. But the underlying CSR bill could be moot, given opposition within the House GOP conference to the subsidies. Rep. Mark Walker (R-NC), chair of the conservative Republican Study Committee, views CSRs as insurer bailouts.

Democrats’ and reproductive rights advocates’ words of caution still stand, given the stakes and the potential for another shutdown in January.

“It is unconscionable that Republicans are holding both government funding and health insurance markets hostage in their quest to deny women access to abortion,” DeGette, the House Pro-Choice Caucus co-chair, said in Tuesday’s statement. “Every woman should be able to make personal decisions about reproductive health care with dignity and respect, and without interference from politicians.”

https://rewire.news/article/2017/12/21/republicans-punt-government-shutdown-manufactured-abortion-crisis/