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40 Years Safe and Legal - Let's Keep It That Way
By Rev. Anne Apple
Posted January 20, 2013

Twelve years ago I walked into a room to interview for a pastoral position in South Alabama. With theological issues boiling tempers, I expected the interview to be confrontational and prepared myself for the questions I'd be asked about homosexuality and who qualified for leadership in the church. What I didn't expect was this "Anne, tell us if one of our teenagers, or your own, came to you and said, I'm pregnant and I want an abortion.' What would you say?" As a mother of two daughters and a son, you bet that question mattered. That question undergirds my decision to serve on the board of Planned Parenthood. At the time, two of our children were inching in on adolescence but the ethics of abortion weren't where I'd invested my preparation for entry into leadership in the church.

Forty years ago this month the U.S. Supreme Court made access to abortion legal nationwide with the historic Roe v. Wade decision. This landmark ruling affirmed that the constitutionally protected right to privacy includes every woman's ability to make her own personal medical decisions, without the interference of government. Four decades later, a majority of Americans still agree with the high court that personal health care decisions should be left up to a woman, her family, her faith and her physician, rather than politicians.

According to a 2012 Gallup poll, 77 percent of Americans think abortion should be legal in some or all circumstances. In poll after poll, a majority of Americans support access to safe and legal abortion in some or most cases. But 40 years after Roe v. Wade, the way people identify with the issue of safe and legal abortion has shifted. No longer do labels like "pro-choice" and "pro-life" reflect the way people think about abortion. Those labels represent false dichotomies. Generations of Americans across party lines and faithful believers understand that abortion is just not that simple. Most people have feelings and opinions about abortion that are complicated. I stand in solidarity with my colleague and friend Reverend Marci Glass, who says, "I remain firmly pro-choice in my pro-life-ness." When faced with the choice herself as a pregnant teenager, though she instantly had compassion for others who have chosen abortion, she placed her son for adoption. She says that without a doubt it was the hardest thing she's ever done in her life, but that she was able because she had a family who wouldn't disown her, friends who stood by her and access to affordable healthcare.
I hold firm to the tenet that politicians should not interfere in a woman's decision about pregnancies and abortion.As we saw in 2011 with the defeat of the "personhood" amendment in Mississippi, voters made it clear again last year that they are opposed to policies that inject politics into medical decisions that need be personal and private. This past November, voters rejected some of the nation's most vocal and extreme opponents of safe and legal abortion. Yet, despite the outcome of the election, politicians in Tennessee chip away at abortion access by making it more difficult for women to obtain or afford. Year after year, legislators in Nashville introduce bills that seek to limit a woman's ability to make her own decision about pregnancy. These laws deconstruct healthy options for women to access safe, legal abortion without interference, as protected by the nation's highest court.

A common ground in women's reproductive rights is that women need access to affordable birth control as a method to reduce the number of unplanned pregnancies. A poll conducted in October 2012 by the National Campaign to Prevent Teen and Unplanned Pregnancy, found that 70 percent of respondents agreed that health insurers should be required to cover birth control. Ninety-five percent of the adults in that poll agreed that for those trying to avoid pregnancy, using birth control is taking personal responsibility. Yes, as is abstinence.

As my colleague says, "If we were pro-life, we would be busily reminding our politicians that children (and their mothers and fathers) need access to health care, education, food, and safe living conditions in order to succeed in this world and to live good and healthy lives. It's sad that the most compelling reason I could think of to get an abortion was so 'good' Christian people wouldn't judge me."

Instead of pursuing legislation that restricts access to abortion, our representatives in Nashville and Washington need to do everything they can to make effective birth control and medically-accurate sex education available to everyone in our state. Not only will it address a glaring unmet health care need, it will probably even reduce the number of unwanted pregnancies and abortions. Changes to Title X Family Planning Program Are an Unfunded Mandate on Shelby County
By PPGMR CEO Barry Chase
Posted April 20, 2011


Socially conservative politicians in Nashville are doing everything they can to prevent women, especially young and poor women, from accessing the health care they need to stay healthy and plan their families. Extremists in the Tennessee General Assembly are trying to impose their radical ideology by putting unreasonable restrictions on a family planning program that serves hundreds of thousands of women in Tennessee merely to punish Planned Parenthood.

Title X of the Public Health Service Act has been in effect since 1970, providing family planning services for those in need in clinics throughout the country. In Tennessee Title X funds support 130 clinics, including Planned Parenthood health centers in Memphis, Nashville and Knoxville. Those clinics serve many of the 350,000 women and teens in Tennessee who need contraceptive services. 20% of those women are uninsured. Planned Parenthood has been a Title X provider in Tennessee since the early 1970's, working closely with the Tennessee Department of Health and local health departments to meet the many requirements of the Title X family planning program.

Title X family planning clinics are an entry point to the health care system for women and teens without insurance and those who do not qualify for TennCare. These clinics help women prevent unintended pregnancies, plan healthy pregnancies, lower rates of sexually transmitted infections, including HIV/AIDS, and detect breast and cervical cancer at its earliest stages when it is most treatable. And to be very clear, long standing federal law prohibits the use of any of these funds for abortion services either directly or indirectly. The Title X funding doesn't cover the full cost of providing preventive services to low-income patients, yet the grant requires providers to continue treating qualified patients after all the grant monies have been spent. The Memphis and Shelby County Health Department doesn't have the financial resources to bear the full cost of providing Title X services. Yet some lawmakers in Nashville want to force our health department to accept all the Title X funding allotted for Shelby County, rather than allowing Planned Parenthood to provide some of the services and share the costs. Being forced to accept all of the Title X funding would actually cost our local health department morecosts that would have to come from local tax revenues. It amounts to an unfunded mandate on local government. It is amazing that lawmakers from Middle and East Tennessee think they know how to run our local health programs and allocate local tax dollars better than we do.

Planned Parenthood is the leading provider of reproductive health care in America. One woman in five in America has turned to a Planned Parenthood health center for care at some point in her life. One of those women is Holly Ashmore of Memphis who says, "When I first moved to Memphis, I was constantly without health insurance, either because I was at a temporary position, or because my small employer couldn't afford it. Throughout those years of not being able to access standard medical care and birth control, Planned Parenthood was there to get me the health care I needed." Thousands of women like Holly who live in the Memphis area rely on Planned Parenthood Greater Memphis Region's services. The Title X family planning program allows Planned Parenthood to serve those women and teens, who may have no other source for reproductive health care. If extremists in the Tennessee General Assembly have their way, they will restrict access to lifesaving health care for thousands of women and teens in West Tennessee. Their plan to punish Planned Parenthood would cost us more in local tax revenues and more importantly, its impact will also be measured in undiagnosed cancers, untreated STIs, and a flood of unintended pregnancies and abortions.

Any public official who considers that a good deal should resign. If our state legislators are serious about health and serious about good governance, they will do what's right and reject this unfunded mandate.

Eliminating Family Planning Program Will Cost More Than it Saves
By PPGMR CEO Barry Chase
Posted April 7, 2011

The U.S. Senate is considering draconian cuts to women's health care that were passed by the House of Representatives, one of which would completely eliminate the national family planning program known as Title X. Another would remove all funding for women's reproductive health provided through Planned Parenthood. For women in Memphis and the Mid-South, this short-sighted maneuvering can only lead to terrible outcomes for familiesoutcomes that will cost taxpayers more in the long run. Title X of the Public Health Service Act has been in effect since 1970, providing family planning services for those in need in clinics throughout the country. In Tennessee Title X funds support 130 clinics, including Planned Parenthood health centers in Memphis, Nashville and Knoxville. Those clinics serve many of the 350,000 women and teens in Tennessee who need contraceptive services. 20% of those women are uninsured. Title X family planning clinics are an entry point to the health care system for women and teens without insurance and those who do not qualify for TennCare. These clinics help women prevent unintended pregnancies, plan healthy pregnancies, lower rates of sexually transmitted infections, including HIV/AIDS, and detect breast and cervical cancer at its earliest stages when it is most treatable. And to be very clear, long standing federal law prohibits the use of any of these funds for abortion services either directly or indirectly. Tennessee has some of the worst health outcomes for women and teens in the nation and Shelby County has the most teen births in the state. In 2009, 2,181 teenagers gave birth in Shelby County, accounting for more than 20% of all teen births in the state
More than 20% of Tennessee teens under the age of 18 live in poverty. Many of them lack health insurance or access to routine health care. Without publicly funded family planning clinics, pregnant teens and women will receive inadequate prenatal care and will be more likely to give birth prematurely and to have low birth weight babies, contributing to Memphis and Shelby County's unacceptably high infant mortality rate. The Guttmacher Institute has calculated that without federally funded family planning programs in Tennessee, we will see a 31% increase in teen pregnancy and a 41% increase in abortion. Every dollar spent on family planning in Tennessee saves more than $6 that would otherwise be spent on TennCare maternity-related costs. Cutting family planning funding does not save moneyit actually costs taxpayers more money in the long run. Senators Lamar Alexander and Bob Corker want to eliminate funding for the preventative health care services that help women plan their pregnancies and reduce the need for abortionservices that also address teen pregnancy and infant mortality. In this era of tight budgets, it makes no sense for our Senators to eliminate funding for programs that actually save taxpayers' money. Our Senators are attempting to score political points on the backs of women and families who have no other access to much-needed health care. Millions of women and men in this country rely on the preventative health care provided by Title X supported health centers. Many thousands of them live right here in Memphis and West Tennessee. We need to let Senators Lamar Alexander and Bob Corker know how important this funding is to our city, our state and the health and welfare of our families. End Cost Barrier to Prescription Birth Control
By PPGMR Nurse Practitioner Leah Smith, RN
Posted 12/14/10

This year marks the 50th anniversary of the approval of the birth control pill. Yet, for millions of women, the price of the pill and other contraceptives is just too high, making birth control simply out of reach. In our current economic climate this is unfortunately more obvious than it has ever been before.

However, a provision in the new health care law may allow all FDA-approved prescription contraception to be fully covered by new health plans. Simply put, that means that women may not need to find cash co-pays or out-of-pocket payments for prescription birth control.

Under the new health care law, health insurance plans will be required to fully cover women's preventive health care services, including birth control, without requiring any co-pays. Over the next year, the U.S. Department of Health and Human Services (HHS) will decide which benefits will be covered at no cost for women.

As a women's health nurse practitioner, I agree with leading medical organizations such as the American College of Obstetricians and Gynecologists, that full coverage of prescription birth control without co-pays is critical for women in our community. This is preventative medicine at its best to reduce the overall cost of health care. Planned Parenthood is at the forefront of offering birth control to women regardless of their ability to pay, but our resources are simply not sufficient to help everyone who needs help. We need a change in national policy.

Planned pregnancies are healthier for both the mother and the baby. Birth control methods allow women to get pregnant when they are physically, emotionally and financially ready to become parents. That results in healthier pregnancies, which would in turn have a positive impact on the tragically high infant mortality rates that plague Shelby County.

In my practice, I see that most women spend three decades of their lives trying to avoid getting pregnant. Since most women today want to limit their families to two children, they spend approximately five years pregnant, postpartum or trying to have children, but 30 years trying to prevent pregnancy. That can add up to thousands of dollars spent on prescription birth control. A survey conducted by Hart Research Associates found that 71 percent of all voters were in favor of fully covering prescription birth control with no co-pays. The number is even higher among women voters, of which 81 percent supported this policy.

The support holds strong across political, religious and ethnic groups. The survey found that 77 percent of Catholic women voters and 72 percent of Republican women voters support covering birth control with no co-pays. Even 60 percent of male voters support this policy.

Most importantly, the survey revealed that fully covering birth control is absolutely necessary. More than one-third (34 percent) of American women voters have struggled with the cost of prescription birth control at some point in their lives, and, as a result, have used birth control inconsistently. That number rises dramatically among younger women, with more than half (55 percent) mentioning a time when they could not afford to use birth control consistently. I have seen in my own practice that lack of access to affordable birth control leads to unintended pregnancies.

This is not surprising, given that out-of-pocket costs for birth control can be very expensive, especially for many young women and women with low incomes. Insurance co-payments for birth control pills typically range between $15 and $50 per month, and for other methods, such as IUDs, co-pays and other out-of-pocket expenses can reach into the hundreds of dollars.
By eliminating this cost barrier and providing prescription birth control with no co-pays or out-of-pocket costs, women will have access to a full range of reliable, safe, and effective birth control methods.

In the United States, half of all pregnancies are unintended. If we are serious about reducing the unacceptably high rate of unintended pregnancies in our country and in our community, we need to get to the root cause and take practical steps to increase access to birth control for all girls and women of child bearing age. The simple fact is that making contraception available reduces the number of unintended pregnancies and allows women to plan their families, improving their own health and the health of their children. That's why I urge everyone to support fully covering prescription birth control with no co-pays and to make your voice heard to your representatives in Washington. I know this change will dramatically improve the lives of families in the Mid-South.

Leah Smith, RN, WHNP
Women's Health Nurse Practitioner
Planned Parenthood Greater Memphis Region

Equitable Health Care for Women
By PPGMR CEO Barry Chase
Posted 12/24/09

For the very first time in American history, after about 100 years of discussion, the United States Senate has passed a comprehensive health care reform bill. This is an historic accomplishment, but it comes at an unacceptable price for American women. Obstacles to private health insurance coverage for abortion were included in the bill to gain the deciding vote of Senator Bill Nelson (D-NE), who opposes reproductive rights for women. This provision must be fixed before the bill becomes law if we are to truly achieve health care reform for all Americans, including women.

The truth is that health care reform was held hostage until the Senate agreed to include language that would require thousands of Mid-South women to unnecessarily write two checks to pay for private health insurance instead of one. One check would pay for abortion coverage and the other would pay for all other care and medical procedures. Health plans would then be required to set up a complex accounting scheme to separately allocate private insurance premiums for abortion and all other procedures. Moreover, none of this complex bureaucracy has anything to do with the stated goal of making sure federal funds are kept separate from the private premiums used for abortion care.

At a time when we are trying to streamline our nation's health insurance system and eliminate waste, why should we force health plans to implement an inefficient and administratively costly system? Any business that asked its customers to buy one product with two checks would soon be closed. Requiring people to write two separate checks for their health coverage doesn't accomplish anything other than the real goal of anti-choice politicians making the system unworkable for women.

At Planned Parenthood in Memphis, almost 90 percent of the health care they provide is preventive in nature, including helping women choose the birth control method that's best for them. What I know, and what is obvious to most Americans, is that women don't plan an unplanned pregnancy or a complication in their wanted pregnancy any more than they plan to have a heart attack or a stroke or cancer. Like all Americans, women in Memphis want health insurance that is there for the unexpected. But like the Stupak abortion ban in the health care reform bill passed by the House of Representatives, the Nelson abortion provision in the Senate bill creates such complicated administrative burdens for health plans that it is highly unlikely insurers would offer abortion coverage at all even for medically necessary abortion care in highly complicated pregnancies.

The American health care system is in dire need of reform and that is evident no place more than locally with the possible closing of services at The Med, the safety net for so many. Families know that health care reform legislation is not the place to re-argue the debate over abortion care. The leaders of Congress must remove the Nelson and Stupak provisions as they shape a final health care reform bill in a conference between members of the House and Senate. These bureaucratic barriers to abortion care don't make for good health policy, and they won't work for women. What we need is a health care bill that treats women and women's health as well and as fairly as it treats men.

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