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/

On the morning of December 13, Teodora Vasquez entered a courtroom in El Salvador, where abortion is banned in all cases, hoping she’d be going home with her parents and son that evening for the first time in a decade. Vasquez had already served ten years of a 30-year prison sentence for aggravated homicide following a stillbirth.

During the new trial in the country’s Second Court of Appeal last week, two expert witnesses testified that no crime had been committed and that the death was from natural causes. Still, the three-judge panel—Judges Alejandro Guevara, José Luis Giammattei, and María del Pilar Abrego—reaffirmed their original decision. Vasquez was sent back to prison to serve out the remaining 20 years of her sentence.

Vasquez’s supporters in El Salvador and internationally see these events as a referendum on the ability of Salvadoran courts to serve the interests of justice, especially for women living in poverty.

In 2007, the 24-year-old Vasquez was working in the cafeteria of a school in San Salvador. Vasquez, who was the mother of a 3-year-old boy, was pregnant and awaiting the birth of her second child. According to repeated testimony she has given over the years, while at work she began to feel intense pains, and knew it was time to go to the hospital. She made several phone calls to the police, who frequently provide emergency transportation in El Salvador, but, she says, they never responded. During the long wait, she felt the need to use the bathroom. There, she says, she felt something fall from her body. She fainted, came to for a few moments, and fainted again.

Eventually, she emerged from the bathroom. When other workers saw the blood from her severe hemorrhaging, they called police. This time, the police arrived and arrested Vasquez, who had lost consciousness again. When she awoke, she says, police were questioning her about why she killed her baby. She was taken to the hospital, and then to prison. In 2008, she was sentenced to 30 years for aggravated homicide.

While in prison, Vasquez became part of the group known as “Las 17,” women convicted of aggravated homicide after experiencing obstetric complications and precipitous births without medical attention. With support from the Agrupación Ciudadana por la Despenalización del Aborto (Citizen Group for the Decriminalization of Abortion) in El Salvador, the 17 women each requested a pardon from the Salvadoran government. All but two requests were denied, including Vasquez’s.

Morena Herrera, Agrupación president, said at a press conference the day after Vasquez’s hearing that the group knows of at least 28 women currently serving sentences similar to Vasquez’s. Two more, she said, are still awaiting trials.

In seeking to gain Vasquez’s freedom, the Agrupación and Vasquez’s attorney, Victor Hugo Mata Tobar, requested a revision of the original conviction. The criminal law branch of the Salvadoran Supreme Court granted the request, but named the same three-judge panel that had convicted Vasquez ten years ago to hear the case. Mata Tobar appealed and asked to have those judges recused, but the higher court insisted the judges could be impartial.

Still, Omar Flores, an attorney with the Salvadoran legal foundation FESPAD, noted his concern at the press conference that, as far as he saw it, “The proceedings gave preference to the prosecutor’s case while ignoring the scientific evidence and studies that demonstrated Teodora’s innocence.”

That evidence included testimony from two witnesses—a Salvadoran OB-GYN and a Guatemalan forensic medical specialist and attorney—who explained that asphyxiation connected to childbirth is not caused by some type of mechanical strangulation carried out by a person, which is what the prosecution accused Vasquez of doing. Rather, this medical phenomenon can happen due to natural causes before, during, or after birth and involves no criminal activity.

After the judges ruled against Vasquez a second time, civil society organizations denounced the double standard under which the judicial system operates in El Salvador. They argued that accused aggressors are “treated with indulgence,” and often allowed to wait for trials out of prison, while women like Vasquez are treated as guilty from the beginning.

Erika Guevara-Rosas, Americas director at Amnesty International, qualified the decision not to release Vasquez as an outrageous step backward for justice.

Although Vasquez was convicted of aggravated homicide and not abortion, a chorus of national and international bodies argued that the country’s anti-abortion law helps create a social and legal climate that leads to the imprisonment of women who have pregnancies that end in the death of the fetus, even when there is no evidence of criminal activity. Many of these organizations renewed their calls for the Salvadoran government to take action to end the practice of prohibiting all abortions and of using the anti-abortion law as part of a mechanism to criminalize women living in poverty who have obstetric complications.

A December 15 press briefing from Liz Throssell, spokesperson for the UN Commission on Human Rights in Geneva, noted that “El Salvador’s Penal Code disproportionately affects women living in poverty, such as Teodora. We have not seen women from wealthier backgrounds jailed under similar circumstances in El Salvador.”

It urged the Salvadoran government to “review all cases where women have been detained for abortion-related offenses. If it is found that these cases were not compliant with international standards, the women should be immediately released.” As the Agrupación announced, the European Parliament had issued a similar resolution on December 14 specifically noting Vasquez’s case, along with that of Evelyn Beatriz Hernandez Cruz.

Throssell concluded, “Basically they are being convicted for being women, for losing a child, and for being poor.”

According to Herrera, the Agrupación is already working with partners such as the Center for Reproductive Rights and Amnesty International to investigate other possible legal avenues to secure Vasquez’s release from prison, both through the Salvadoran courts and through the Inter-American  Court of Human Rights (IACHR). The IAHRC has already admitted—meaning accepted and will have hearings for—other cases of Salvadoran women with similar convictions.

Vasquez stated before the hearing that she had confidence that the court would “rectify the error” because “I know I am not guilty.”

The Agrupación will also continue exploring legal options for the other women behind bars. As Herrera told Rewire, “The citizenry of this country—but above all those who live in situations of poverty—do not have their rights protected when facing the judicial system.”

Source: https://rewire.news/article/2017/12/20/sentenced-30-years-stillbirth-teodora-vasquez-will-return-prison/

UPDATE, December 19, 9:13 a.m.: A federal judge on Monday issued a temporary restraining order barring Trump administration officials from preventing the two teenage immigrants from seeking abortion care. The administration said it would allow one of the teens to receive abortion care, but requested a stay for the other teen, the Los Angeles Timesreported.

After losing its fight to keep Jane Doe—a teenager whose abortion care was delayedbecause of court proceedings—from making her own reproductive health-care decisions, the federal Office of Refugee Resettlement (ORR) is once again attempting to block unaccompanied immigrant minors from accessing care.

Little is known about the two teenage girls, known as Jane Roe and Jane Poe,requesting access to abortion. Minors in ORR custody are often asylum-seeking young people from Central America. Many young women are escaping gender-based violence. Brigitte Amiri, senior staff attorney with the American Civil Liberties Union’s (ACLU) Reproductive Freedom Project, told Rewire in Octoberthat many of the girls and women in ORR’s care are pregnant as a result of being raped on their journey to the United States. Amiri said the stats for unaccompanied immigrant minors are similar to those of other migrant women. An estimated 80 percent of Central American women crossing Mexico en route to the United States are raped along the way, according to a 2014 report from Splinter.

Amiri was in court Monday, requesting an emergency order to prevent the Trump administration from denying the teenagers access to care based on a new ORR policy devised by anti-choice advocates.

The Trump administration in March implemented a revised policy “that allows [shelters] to wield an unconstitutional veto power over unaccompanied immigrant minors’ access to abortion,” according to court documents. This directive prevents unaccompanied immigrant minors in ORR’s care from obtaining abortion care by prohibiting federally funded shelters from taking “’any action that facilitates’ abortion access to unaccompanied minors in their care without ‘direction and approval’” from ORR Director Scott Lloyd. Advocates charge that Lloyd is a religious fanatic unqualified for his position as ORR director. He is considered by advocates to be an ideological pick by the Trump administration.

Lloyd has gone to great lengths to coerce immigrant teens to carry unwanted pregnancies, including using taxpayer funds to fly to shelters to “counsel” teens about their choices, despite admitting to having no counseling or medical experience. Lloyd has a well-documented history with so-called crisis pregnancy centers (CPCs), or fake clinics, which provide people with false information to dissuade them from seeking abortion care. These clinics compose almost all of the approved counseling centers listed by ORR for minors requesting abortion care. An investigation by Reveal found that this list came from the anti-abortion advocacy group Heartbeat International, whose mission is “to make abortion unwanted today and unthinkable for future generations.”

The Department of Health and Human Services’ (HHS) Administration for Children and Families, the agency that oversees ORR, is arguing that because Jane Roe and Jane Poe entered the United States without authorization, they can “voluntarily depart to their home country or find a suitable sponsor,” according to the Washington Post. If the girls choose not to return to their countries of origin or cannot find a suitable sponsor, “HHS does not believe [it’s] required to facilitate the abortion.”

The government made the same arguments in Jane Doe’s case. During an October hearing, Amiri said that if Jane Doe was an adult in an immigrant detention center overseen by Immigration and Customs Enforcement or was an undocumented adult in prison for committing a crime, her abortion care would not have been delayed. But because she was a minor in legal custody of ORR—and ORR maintains an interest in “fetal life and child birth”—the teen was forced to carry an unwanted pregnancy.

When asked by the court to clarify why Jane Doe could access abortion care as an undocumented adult in detention or prison but not as an undocumented minor detained in a shelter, the government’s counsel said the difference was that Jane Doe has the option of “voluntary departure.” Voluntary departure means that Jane Doe, who fled an abusive home in Central America where her teenage sister was beaten by her parents for being pregnant, could have self-deported to her country of origin, where abortion is illegal. The government argued that presenting voluntary departure to Jane Doe as her primary option did not constitute an undue burden.

Sponsorship is not easy to come by for immigrant girls seeking abortion care in ORR custody. Jane Doe has been in ORR custody for months and has had multiple sponsors denied by the agency. In November, Amiri told Rewire she doesn’t know the reason the teen is still in custody. A federal appeals court on October 20 gave the teen until October 31 to secure a sponsor so that she could access abortion care, and the federal government said it could find Jane Doe a sponsor by that date. But as of November 30, Jane Doe was still without a sponsor. This means that had Jane Doe’s attorneys not continued to fight for her to access care sooner than the October 31 deadline, she would have passed the 20-week mark and been forced to carry an unwanted pregnancy; ultimately, she was able to secure abortion care. Part of the reason Jane Doe may not have secured a sponsor is because the government is fighting for the ability to inform any potential sponsor that Jane Doe has accessed abortion care, a violation of her rights.

An ACLU spokesperson told Rewire they are anticipating a decision regarding the emergency order for Jane Roe and Jane Poe “within hours” of today’s 10:30 a.m. ET court hearing. The ACLU is expecting the federal government to “immediately appeal” the decision, with the possibility of the case quickly heading to the U.S. Supreme Court.

Source: https://rewire.news/article/2017/12/18/trump-administration-continues-blocking-immigrant-teens-accessing-abortion-care/