Q&A: Fighting for Women in the States

The 2010 midterms brought into office 29 anti-choice governors, raising the number of states with both anti-choice majority legislatures and governors to 15. Pro-choice advocates fear the next two years will bring a marked increase in state-level restrictions to abortion access.

Nancy Northup, president of the Center for Reproductive Rights, is anticipating a very busy year. Northup gave TAP the rundown on women's reproductive health coverage under the Affordable Care Act and attempts to stall expanded access to emergency contraception.

This week is the 38th anniversary of Roe v. Wade. I recently finished reading Before Roe v. Wade by Linda Greenhouse and Reva Segal, and I was struck by some of the similarities in the political fights between then and now. How are things different from before Roe, and how are they the same?

Obviously, the biggest difference from a medical-services perspective post-Roe is that we do now have women in all 50 states, not just the three states that legalized abortion before Roe v. Wade, able to, in theory, get access to abortion services. The political battle today is astonishingly vibrant. For those of us in reproductive rights … it's troubling that these 38 years since Roe v. Wade that we are still enmeshed in the politics of this and have not had it strongly enough protected as a rights issue.

Reproductive rights fared poorly at the state level last year. Your organization released a report [PDF] on the various kinds of anti-choice legislation that passed in 2010, including ultrasound requirements for women seeking abortions and parental notification requirements for those under 18. What might we expect to see come out of state legislatures this year?

We are usually tracking over 500 anti-choice bills every year, and we expect this year, because there were more anti-choice governors elected, to see a huge deluge of anti-choice laws. What we are hoping for is that legislators think twice about passing laws that interfere with a woman's personal medical decision. The election was not about access to reproductive-health services including abortion services, and women in those states should not be subjected to further restrictions, because other issues were at play in the last election.

Some states, like Mississippi, are blocking abortion coverage for private insurers and other aspects of the Affordable Care Act. What does that mean for women?

The debate over abortion health-care reform was a major impetus for these aggressive efforts in the states to restrict abortion access to insurance coverage. Some of the bills we were looking at last year have banned coverage for abortions with no exceptions at all. So they're even more restrictive than the restrictive provisions of the Nelson amendment in health-care reform.

We had five states pass laws that don't allow you to purchase, with your own money, an insurance plan that covers abortion services. This is hugely problematic, because obviously, people purchase insurance to protect themselves from unpredictable, difficult, and expensive health-care costs, and these states are restricting women's ability to do that.

What other challenges to reproductive health care will we see this year?

There's going to be a continued attempt to restrict private insurance plans from covering abortion services. We also expect to continue to see biased counseling laws, mandatory ultrasound laws, as well as unnecessary burdens states keep putting on the providers of abortion services [also known as targeted restrictions on abortion providers, or TRAP laws, which can include everything from added paperwork to restrictions on how facilities that provide abortions can be built] and thus block women's ability to access abortion services.

What other aspects of reproductive health might be affected by increasing anti-choice sentiment in the states?

Last year, we saw some very extreme outlier bills that would identify full personhood from the moment of conception. These bills, if they were to become law, would potentially ban all kinds of contraception that interfere with implantation, so hormonal birth controls, [intrauterine devices], etcetera. These extreme measures have implications not just for abortion services but also for very common and widely used contraception.

Is there any encouraging news on reproductive justice?

One of the potentially encouraging pieces of news is how under the new health-care legislation, federally, contraception is going to be a preventative service, which therefore will be covered without a co-pay. That would be an absolute huge win for women's health, and no one will be unable to purchase contraceptives because of financial barriers.

Most women spend much of their adult lives trying to prevent an unintended pregnancy. If contraception is -- as it should be -- viewed as a preventative service, that's going to be hugely important for American women and for understanding how central to women's health it is to be able to prevent unintended pregnancies.

What litigation is the Center for Reproductive Rights working on?

We had the largest litigation docket we've had in over a decade because there has been such an attack on access to abortion services at the state level. The cases we're doing in Oklahoma on mandatory sonogram laws and the cases we're doing in Louisiana on the treatment of abortion services as separated from the way the state treats other medical services are going to be significant cases to follow.

We also have recently filed a contempt motion against the [Food and Drug Administration], because two years into the Obama administration, we still have not seen compliance with the district court's order that they take another look at the restriction on access to emergency contraception, which right now is not available for purchase without a prescription for those under 17. The agency has seen that it is safe and effective for women of all ages and is not subject to other points of sale restrictions. A federal court in New York has ordered the Obama administration take another look at these issues, and today they haven't done anything. I think the issue of emergency contraception could be getting a fair amount of attention.

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