As the Year Winds Down, No Sign Attacks Will End

For family planning supporters, every day is a new (and mostly unpleasant) adventure under Donald Trump. Here’s what the last quarter of the year brought us.

Budget Outcome Remains Unsettled

In our last issue, I wrote about the House version of the State Department/Foreign Operations Appropriations bill. To recap: It was really, really bad. It limited funding for international family planning to not more than $461 million and codified Trump’s expanded Global Gag Rule and the ban on funding for the United Nations Population Fund (UNFPA). Democrats offered amendments to fix these problems, but they were defeated 23-29, with only retiring Rep. Charlie Dent (R-PA) crossing party lines to vote with the Democrats.

The Senate Appropriations Committee met in early September to consider their version of the bill. Initially, it wasn’t any better than the House bill. However, the outcome in committee was quite a bit better. During markup, Sen. Jeanne Shaheen (D-NH) offered an amendment to increase funding to $585 million, remove the Gag Rule and insert the language of the Global HER Act, and allocate $37.5 million for UNFPA. The amendment passed 16-15, with Sens. Susan Collins (R-ME) and Lisa Murkowski (R-AK) voting for the changes, along with all Democrats except for West Virginia’s Sen. Joe Manchin.

The disparities between the two bills will have to be worked out before there can be any vote on a final funding package.

Because it was believed to be unlikely that both chambers would get all their funding bills done by the end of the fiscal year (September 30), Congress had already passed a three-month Continuing Resolution, which will fund the government at current levels through December 8.

“The Global Gag Rule is a dangerous and ill-conceived policy that blocks millions of women and their families from receiving critical aid and assistance. . . I’m very pleased that this amendment was approved on a bipartisan basis and hope that Congress can continue to make progress to repeal this disastrous policy.”
– Sen. Jeanne Shaheen

House Passes 20-Week Abortion Ban

In early October, the House passed a bill to ban abortion nationwide after 20 weeks of pregnancy. The justification for the measure, which passed 237-189, was the medically dubious theory that a fetus can feel pain by that point in a pregnancy. The bill contains exceptions for pregnancies caused by rape and incest, and for those that are life-
endangering to the pregnant woman. It does not, however, allow for abortion in cases where there is a fetal anomaly. Although Donald Trump has vowed to sign it if it reaches his desk, the bill currently remains mostly a symbolic gesture, since passage in the Senate would require 60 votes.

Trump Administration Rolls Back Birth Control Benefit …

Only days after the passage of the House abortion bill, the Trump administration added its own attack on reproductive rights: the rollback of the Affordable Care Act’s birth control benefit.

At least 55 million women have gained access to birth control without a copay since the benefit was first introduced. In 2013 alone, birth control pill users saved $1.4 billion in out-of-pocket costs. Upfront costs for IUDs — one of the most effective long-acting
methods — fell to $0 for most women with insurance.

The new rule specifically says that the ACA does not require that birth control be covered. And it dramatically expands the religious and “moral” exemptions that were the result of the Hobby Lobby case in 2014. Previously, entities that objected to covering birth control had to notify the government that they would not comply. Insurers were then required to offer separate birth control coverage at no additional cost to the affected employees. The new rules do away with all of that. They let any employer, large or small, religious or secular, assert a religious or moral objection to birth control and refuse to cover it. They don’t have to notify anyone but their employees, and insurers don’t have to do anything in response to offer the coverage to enrollees.

Part of the administration’s stated rationale for the change? Access to birth control might promote “risky sexual behavior” among teens and young adults.

And as with so many of the actions taken by this administration, they’re not even pretending to follow the normal process for making changes like this. Most regulatory changes go through what’s called a “notice and comment” period before they take effect. It’s done so groups or individuals affected by the changes have an opportunity to have their objections heard. Not so with this change — the new rules were final as soon as they were issued.

In response, Senate Democrats, led by Patty Murray (D-WA) released a bill designed to undo the rollback. A group of Democratic women in the House have indicated that they will release companion legislation soon. Additionally, multiple advocacy groups and the attorneys general for several states have already either filed suit against the administration, or announced that they plan to do so.

… and Undercuts the ACA

Removing the birth control benefit wasn’t the only attack on the ACA. Congress failed to repeal the healthcare bill, but the administration is doing everything in its power to make sure it doesn’t work anymore. They had already refused to allow states to make requested fixes to their marketplaces. They cut the advertising budget so people wouldn’t know they needed to sign up, and limited the open enrollment period to create less opportunity. And then, shortly after the birth control rule change, Trump announced that he would not make the cost-sharing payments required by law — payments that help prevent premiums from skyrocketing for some customers.

Soon after that decision, a bipartisan group of senators, led by Lamar Alexander (R-TN) and Patty Murray (D-WA) announced that they had arrived at an agreement that would make the payments and stabilize the marketplaces. As of our deadline, Trump had spent several days waffling on whether he would support the measure, and Speaker Paul Ryan had made no comment.

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