Roe v Wade Anniversary: Pro-Active Legislative Agendas

Logo for the Pennsylvania Agenda for Women's Health

Logo for the Pennsylvania Agenda for Women’s Health

Today is the 41st anniversary of the Roe v. Wade decision by the US Supreme Court that says that women have a constitutional right of access to safe abortion services throughout the country.  Since 1973, the right-wing has been pushing back and chipping away at this right. These attacks over the decades have expanded beyond access to abortion and now include all areas of family planning and access to women’s health care. As a result, women’s rights and reproductive justice advocates have been on the defense in an attempt to ensure that all women of reproductive age have full access to all forms of reproductive health.

For a very long time, conservatively controlled legislatures have narrowly focused on restricting women’s access to abortion and reproductive health services. We need a pro-active legislative agenda at the national and state levels to counter this chipping away of our basic rights.  And this is starting to occur.

It’s something we need to focus on, spread the word about, and celebrate on this 41st anniversary of the Roe decision.

Advocates for reproductive justice have had some success in 2013 in their pushback on our back reproductive and healthcare rights.  For example, Texas Senator Wendy Davis, with the assistance of thousands of advocates crowding the capital successfully delayed the passage of an onerous anti-abortion law. And the city of Albuquerque voted down an anti-abortion referendum.

Legislatures too have started to pushback.  And that’s what I’d like to focus on today. Two states so far have decided to take a pro-active stance – New York and Pennsylvania.

New York

Last year, New York State decided to fight back with their “9 Point Plan for Women’s Equality.”  This plan, known as the Women’s Equality Act covers nine broad areas of concern:

  1. Safeguarding Reproductive Health by a) codifying the 1973 Roe v Wade decision, b) ensuring that women can obtain a safe, legal abortion during the first 24 weeks of pregnancy; c) ensuring that physicians won’t be prosecuted for providing this care; and d) retaining the provisions in current law that would prosecute those who harm women;
  2. Ending Pregnancy Discrimination by requiring employers to make reasonable accommodations for pregnant women in the workplace;
  3. Fighting Human Trafficking by a) creating an “affirmative” defense of being trafficked when a person is charged with prostitution, b) increasing penalties for both sex and labor trafficking, c) creating the ability for victims of trafficking to take civil action against their perpetrator, and d) creating some new criminal offenses in increasing level of severity for some forms of trafficking;
  4. Supporting Domestic Violence Victims by creating a pilot program to allow victims of domestic violence to testify remotely against the alleged perpetrator of violence when requesting a protection from abuse order;
  5. Creating Fair Access to Housing by adding source of income and status as a domestic violence victim to the state’s anti-discrimination law;
  6. Ending Familial Status Discrimination in Employment by adding protections in the state’s anti-discrimination law for employees who have children 18 years or younger residing in the home;
  7. Allowing Payment of Attorney Fees by granting litigants who win a sex discrimination case the ability to receive attorney fees as part of the settlement;
  8. Improving the Sexual Harassment Law by expanding the prohibition on sexual harassment in the workplace to employers with fewer than four employees so that all places of employment are covered; and
  9. Securing Equal Pay by a) closing a loophole in New York’s law that allows employers to justify lower wages for women, b) outlawing wage secrecy policies, and c) increasing damages to prevailing litigants for up to 300% of unpaid wages.

In June 2013, Governor Cuomo’s Women’s Equality Act was blocked in the NY State Senate because there were enough right-wing legislators who decided to quash the bill due to a provision in the package bolstering access to abortions. However, advocates have not given up. Governor Cuomo has renewed his commitment to passage of the Women’s Equality Act and advocates in New York State are gearing up for another run for successful passage of this bill.

Pennsylvania

Pennsylvania legislators recognized this positive effort from our sister state to the north.  In September 2013, a group of Senators and Representatives from both sides of the aisle formed a new legislative caucus to proactively focus on women’s health and equity.  It is called the Women’s Health Caucus. This bi-partisan caucus is co-chaired by Representative Dan Frankel, D-Allegheny and Senators Judy Schwank, D-Berks and Chuck McIlhinney, R-Bucks.

Rather than the narrow efforts commonly seen in Pennsylvania General Assembly to restrict women’s access to reproductive health programs, the Women’s Health Caucus was formed to redirect legislation towards a woman’s health equity agenda. This broad, proactive agenda covers reproductive health, women’s economic security, and women’s safety.

To celebrate the 41st anniversary of Roe v. Wade, I decided to summarize the bills that have both been introduced and those that are in the works for introduction later this year that focus on some portion of women’s reproductive health and focus on some of the other bills at a later date. This is a work in progress by the Women’s Health Caucus and as such, there may be more bills in process that I don’t yet know about.  The ones discussed here are the health-related bills that have been introduced or have been discussed as potential bills by the Caucus.

Bills in Pennsylvania Legislature to Honestly Address Women’s Needs

As I stated in a blog in September reporting on the first meeting of the Caucus, the Women’s Health Agenda package of bills can be divided into three groups—reproductive health issues, women’s safety, and economic sustainability.  The focus here today is on the bills associated with reproductive health.

On December 11, 2013, the Women’s Health Caucus introduced the first seven bills in the Pennsylvania Agenda for Women’s Health.  Four of the seven bills announced that day focus on some aspect of women and children’s health.  Three of these bills have been introduced and are currently in committee in at least one, if not both, Houses.  The fourth bill is still being circulated for co-sponsors in both the House and Senate.

Healthcare-Related Bills that Have Been Introduced and are in Committee

Sanitary conditions for nursing mothers

This legislation requires employers to provide a private, sanitary space for employees who need to express breast milk. It fixes two main loopholes that are present in federal law under the Affordable Care Act. It would apply to all employees, including those that are exempt from federal overtime provisions. It also requires employers to provide a private, sanitary space for mothers to express milk beyond one year after birth. This legislation mirrors the federal provision that exempts small employers from these requirements if these requirements present an undue hardship on the employer. Representative Mary Jo Daley is the prime sponsor of this bill in the House of Representatives.  It was officially introduced H.B. 1895 on December 12, 2013 with 22 co-sponsors and is awaiting first review in the House Labor and Industry Committee.  There is not a companion Senate bill yet.

Representative Daley describes this workplace need for nursing mothers:

“Study after study makes it abundantly clear – both mothers and children benefit from breast milk. For most babies, especially premature babies, breast milk is easier to digest than formula and helps fight against disease. According to the U.S. Department of Health and Human Services, the cells, hormones, and antibodies in breast milk help protect babies from illness. For mothers, breastfeeding is linked to a lower risk of health problems such as diabetes, breast and ovarian cancers, and postpartum depression. Moreover, breastfeeding mothers miss fewer days from work because their infants are sick less often.

Currently, approximately two dozen states have laws on the books relating to expressing milk in the workplace. Sadly, Pennsylvania does not. The only applicable law on breastfeeding that applies to employers in the Commonwealth is the Affordable Care Act’s amendment to the federal Fair Labor Standards Act. This federal law requires employers to provide a private, sanitary space for non-exempt employees to express milk for up to one year after the birth of a child. However, exempt employees include those that are on salary (exempt from federal overtime provisions), often in managerial positions.”

Ensuring access to health care facilities:

This legislation creates a 15-foot buffer zone around health care facilities where picketing, patrolling or demonstrating that blocks patients’ access to the facilities would be banned. H.B. 1891, sponsored by Representative Matt Bradford, D-Montgomery, was introduced into the House with 23 co-sponsors on December 12, 2013 and is currently awaiting review in the House Health Committee.  S.B. 1208, sponsored by Senator Larry Farnese, D-Philadelphia, was introduced into the Senate with 8 co-sponsors on January 16, 2014 and is currently awaiting review in the Senate Public Health and Welfare Committee.

Representative Bradford describes his bill this way:

“Safe and unfettered access to health care facilities should be the right of all Pennsylvania women seeking medical counseling and treatment.  Accordingly, I plan to introduce a bill prohibiting a person from interfering with a person’s right to seek medical services by knowingly patrolling, picketing, or demonstrating in a very limited zone extending fifteen feet from a health care facility, or driveway or parking facility.

Please know this legislation is not intended to limit the free speech rights of any individual.  Other states including Colorado and Massachusetts, and some municipalities such as Pittsburgh have instituted “buffer zone laws.”  These laws were not imposed on a whim; they were a response to increasing threats, confrontation and even deadly violence. It is important to note that buffer zones have been credited, in part, with toning down volatile instances and confrontations.”

Senator Farnese, using his own experience as a clinic escort, describes the legislation he has introduced:

“This legislation will provide safe access to essential health care services when patients are seeking family planning and reproductive health services.  Often, patients seeking services at a healthcare facility are verbally and physically harassed and intimidated.  Having had experience as an escort for women into health care facilities, I have seen first-hand the potential for violent confrontations between patients and demonstrators.

This legislation will be carefully crafted to ensure that patients have unimpeded access to medical services while still protecting First Amendment rights to communicate a message.  In order to ensure both parties’ rights and safety are maintained, this legislation will provide clear guidance regarding restricted entry zones around entrances and driveways of medical facilities.

Currently, Pennsylvania has no such statewide buffer zone.  Two municipalities, Harrisburg and Pittsburgh, have enacted buffer zone ordinances.  Providing for a content-neutral buffer zone at all medical facilities in Pennsylvania will promote the health and welfare of those who visit those facilities for services while maintaining protection for those individuals who would voice their constitutionally protected speech outside such a facility.”

Increased eligibility for breast and cervical cancer screenings:

This legislation allows women between ages of 30 and 65 to apply and qualify for the state Healthy Woman Program. H.B. 1900, sponsored by Rep. Maria Donatucci, D-Philadelphia/Delaware, was introduced on January 2, 2014 and is awaiting review in the House Human Services Committee.  There is not a companion Senate bill yet.

Representative Donatucci describes the need for greater access to breast and cervical cancer screening:

“The statistics surrounding breast and cervical cancers are truly alarming. According to the Centers for Disease Control and Prevention (CDC), in 2010, 206,966 women were diagnosed with breast cancer in the United States, and 40,996 women died from the disease.  Except for skin cancer, breast cancer is the most common cancer among American women and is one of the most deadly. While the risk of contracting breast cancer increases with age, large numbers of young women face the reality of this disease every year. With regards to cervical cancer, the disease is often not diagnosed because of missed opportunities for screening, early diagnosis, and treatment. All women are at risk for the disease, but it is most common in women over the age of 30. Each year, about 12,000 women in the United States get cervical cancer.

Act 74 established a program to support breast and cervical cancer screening services to low-income, underinsured, and uninsured women 40 to 49 years of age through DoH’s Healthy Woman Program. Before the implementation of Act 74, the program only had sufficient federal funding to provide these screening services to women ages 50 to 64. Today, the program is funded through a combination of department funds and through a grant DoH receives from CDC. My legislation will increase access to these important health screenings [by lowering the age of initial access to women.  This would] allow women between the ages of 30 and 65 to qualify for the Healthy Woman Program if they meet all other applicable requirements. The statistics show that these types of cancer are not confined to women of a particular age. As such, screening qualifications should be expanded in this state to reflect this reality. The money we spend on screening today saves thousands in treatment costs down the road.”

Co-Sponsorship Memo Being Circulated

Workplace accommodations for pregnant women:

This legislation requires an employer to make reasonable accommodations related to pregnancy, childbirth or related medical conditions unless those accommodations would prove an undue hardship on the employer’s operations. Two bills, one in the House and one in the Senate were announced on December 11, 2013.  H.B. 1892 is sponsored by Representative Mark Painter, D-Montgomery; and S.B. 1209 is sponsored by Senator Matt Smith, D-Allegheny. Both bills are currently being circulated for co-sponsors.

Senator Smith’s co-sponsorship memo summarizes his bill (S.B. 1209) this way:

“Currently, federal law protects women from being fired or otherwise discriminated against due to pregnancy; however it does not require employers to provide pregnant women with certain necessary and temporary accommodations to ensure their health and safety during pregnancy. My legislation would bridge this gap.

Three-quarters of women entering the workforce will be pregnant and employed at the same time during their careers, and my legislation would ensure that they can balance each part of their life in a way that is safe and practical for all parties involved.”

Representative Painter has named his version of this legislation The Pennsylvania Pregnant Workers Fairness Act.  His co-sponsorship memo describes HB 1892 this way:

“This year marks the 35th anniversary of the federal Pregnancy Discrimination Act (PDA).  The PDA amended Title VII of the Civil Rights Act of 1964 to prohibit employment discrimination due to childbirth, pregnancy, or similar related medical conditions.

Today, unfortunately, pregnancy discrimination remains a persistent and growing problem.

In the majority of cases, the accommodations women need are minor, such as permission to sit periodically, the ability to carry a water bottle, or help lifting heavy objects.  Those women who continue working without having these medically-advised accommodations risk their health and increase the likelihood of pregnancy complications.

Pregnancy discrimination causes significant and long-term harm to women and their families well beyond pregnancy, to include the loss of health benefits, job seniority, and wages.  These losses also contribute to measurable long-term gender-based pay differences.

The Pennsylvania Pregnant Workers Fairness Act would make it unlawful for a covered entity to refuse reasonable accommodations related to pregnancy, childbirth or related medical conditions unless those accommodations would prove an undue hardship on the entity’s operations.”

Other Women’s Healthcare Bills in Pennsylvania that Are Being Discussed but Have Not Yet Been Introduced

As I mentioned in my blog at the end of September when the Women’s Health Agenda Caucus first met, there are a total of at least 24 bills that are/will be part of the “Agenda for Women’s Health.”  At least two of these bills are directly related to Reproductive Justice and Health. They were not part of the original roll-out, but are somewhere in the process of being written and/or circulated for co-sponsorship. I do not know when these bills will be introduced.

  • Inmate Shackling: Strengthen pregnant inmate shackling law (Act 45 of 2010) to cover the entire pregnancy and a reasonable postpartum period for mother-child bonding and to eliminate the tasering of any incarcerated woman known to be pregnant.
  • Medical Professional Conscientious Right to Refuse to Deliver Medically Inaccurate Information: Protect physician-patient relationships from political intrusion.

So on this 41st anniversary of Roe, I will celebrate this day by reiterating a statement I made on December 11, 2013:

“The ideas for change in this package of bills come from real-life stories of women. They include calls to service agencies, cries for help on hot lines, requests for advocacy, and lots of research to back up the anecdotal stories. As advocates, we realize there are other areas of concern, but believe the Women’s Health Caucuses’ agenda items are a great start.”

Thanks to everyone who is working for these two pro-active women’s health agendas. Thanks to the advocates across the country who have taken the momentum to stand up for our lives. And have a great Roe v. Wade Day as we go on the offense for women’s health and lives.

Pennsylvania’s Proposed Women’s Health Agenda

Kate Michelman

Kate Michelman discussing strategy with women’s health care advocates and members of the General Assembly Health Care Agenda Caucus.

Yesterday (Monday, September 30, 2013), I attended a two-hour meeting with Pennsylvania’s House and Senate members of the joint Women’s Health Agenda Caucus led by Representative Dan Frankel of Pittsburgh. Some of the advocacy groups attending the meeting included the Women’s Law Project (WLP), Women Vote PA, and members of the Pennsylvanians for Choice coalition including Pennsylvania NOW whom I represented.

For a very long time Pennsylvania has focused on restricting women’s access to abortion services – currently accounting for over 1270 pages of legislation and regulations in the state.  This wrong-headed approach to health assumes that women’s sole need is to protect them from safe, legal access to decent abortion care services.  In other words, the state has wrong-headedly been crafting laws and regulations to deny access to abortion, sending more and more women to the back alleys similar to the Gosnell clinic and ignoring the broader issues of women’s health equity.

Women’s concerns about their health are broadly based in bias based on gender. Terry L. Fromson, Amal Bass, Carol E. Tracy, Susan Frietsche of the Women’s Law Project  created a report entitled Through the Lens of Equality: Eliminating Sex Bias to Improve the Health of Pennsylvania’s Women in 2012.  The WLP is Pennsylvania’s feminist legal organization that engages in litigation, advocacy, and education to ensure women’s equality and treatment in Pennsylvania. This report set the context for yesterday’s meeting.  The WLP framed the health care agenda as follows in this report and in the meeting this morning:

The legal and social status of American women has changed dramatically in the last fifty years. Half a century ago, it was legal to segregate jobs by sex, to refuse to hire or promote on the basis of a person’s sex, to fire women who became pregnant, and to limit the number of women admitted to professional schools such as law and medicine. Sexual and domestic violence were hidden from public view and public policy. Abortion was illegal and the birth control pill was not yet on the market. Today, women have taken their place in the working world and educational opportunities for women have expanded exponentially. Sexual and domestic violence are recognized as crimes and some resources are available to its victims. Abortion is legal and birth control is available.

Despite these advances, deeply embedded cultural biases and stereotypes about women’s place in society continue to impede women’s equal participation in society. In our homes and communities women are subjected to violence, poverty, and the burden of care taking responsibilities. In the workplace, women are paid less than men for the same work, remain concentrated in stereotypically female low-paying occupations, are subjected to sexual harassment and discrimination on the basis of pregnancy and care giving, and are denied advancement to managerial and higher paying positions. In school, young women are denied their fair share of sports opportunities and are sexually harassed and violated. Women are denied essential reproductive health care and subjected to discrimination in access to insurance coverage. Women pay more than men for the same coverage, and pregnancy is a preexisting condition that often denies pregnant women access to insurance coverage and therefore maternity care.  Access to abortion has been limited by burdensome legislative requirements, and providers and patients have been terrorized by an increasingly violent opposition. Attacks on access to contraceptive services have grown.

While many laws have been adopted to eliminate sex discrimination at work and at school, gaps persist that must be filled and enforcement needs to be strengthened. This is particularly true in Pennsylvania. While some Pennsylvania cities have outlawed employment discrimination on the basis of care-giving responsibilities and provide other accommodations for women who work, the Pennsylvania legislature has failed to adopt a statewide prohibition on discrimination on the basis of caregiver status or to provide family leave for caregivers. In Pennsylvania, the law permits insurers to price the cost of health insurance higher for women than for men, resulting in women paying more for individual health insurance policies and small employers paying more for health insurance for a predominantly female workforce. Pennsylvania’s sexual assault laws have for the most part eliminated discriminatory provisions, but the myths and stereotypes that continue to infect the criminal justice system hinder the investigation and prosecution of these crimes. The health care perspective on domestic violence and sexual assault is far too limited. Sexual assault is treated as a health care matter primarily in the immediate aftermath of a rape, even though the physical and emotional health consequences can be long lasting. Although a number of health care providers recognize that domestic violence is also a health issue, screening for domestic violence in health care settings is not universal. Poverty, which disproportionately impacts women, exacerbates the impact of sex bias in all of these realms….

Pennsylvania, with 6.5 million women, has consistently been found deficient in national studies on women’s health care measures. In their 2010 health report card, the National Women’s Law Center and Oregon Health & Science University placed Pennsylvania 32 among the 50 states and graded it unsatisfactory with respect to the status of women’s health….

To alleviate women’s health problems, it is necessary to eliminate adverse experiences — discrimination and bias — early in life and throughout life — and to improve access to health care, with an emphasis on care essential to women (pp. x-xii).

Representative Frankel heard this call to refocus the legislature from attacking women’s reproductive health to focusing — just like New York state’s “10 Point Plan for Women’s Equality” — on redirecting legislation in the General Assembly towards a women’s health equity agenda. So yesterday, almost 20 legislators from both houses attended a meeting with advocates seeking to improve women’s lives and health through a broad review and revision of Pennsylvania law.  The agenda covers reproductive health, women’s economic security, and women’s safety.

The ideas for change come from real-life stories of women in the state.  Calls to service agencies. Cries for help on hot lines. Requests for advocacy. And of course lots of research to back up the anecdotal stories.  The 24 suggested changes to Pennsylvania law that were presented are in areas where either no legislation has been introduced or where legislation to improve the bias are lagging or need to be revisited.  We, as advocates, understand that there are other areas of concern, but believe these health care agenda items are a good start.

Some of these ideas are conceptual at this point. Some have some preliminary model wording for new legislation, and some are already in the works.  Here’s the agenda:

Protect and Expand Women’s Reproductive Health Rights

  1. Pregnancy Accommodations:  Require employers to provide accommodations to pregnant employees with temporary pregnancy-related conditions to allow workers to remain employed throughout their pregnancies while imposing minimal burdens on employers.
  2. Support for Breastfeeding Mothers in the Workplace: Require all employers to provide compensated break time and a private, sanitary (not a bathroom) for all employees who need to express milk.
  3. Buffer Zones:  Enact a statewide reproductive health care clinic buffer zone statute to protect safe access to essential health care.
  4. Inmate Shackling: Strengthen pregnant inmate shackling law (Act 45 of 2010) to cover the entire pregnancy and a reasonable post-partum period for mother-child bonding and to eliminate the tasering of any woman known to be pregnant.
  5. Medical Professional Conscientious Right to Refuse to Deliver Medically Inaccurate Information: Protect physician-patient relationships from political intrusion.

    Improve Women’s Economic Security

  6. TANF (Temporary Assistance to Needy Families) Grant Amount: Increase TANF cash assistance grant levels.
  7. TANF Asset Limit: Increase the TANF eligibility asset limit to encourage saving and financial independence.
  8. Earned Income Disregard: Increase the earned income disregard and apply it to applicants as well as recipients.  FYI, the earned income disregard allows very-low income workers to continue receiving TANF, food stamps, and Medicaid if they make 50% or less of the poverty level.  This proposed legislation would raise this “disregard” level to 75% and would apply to applicants as well as recipients.
  9. Childcare Works Waiting List: Eliminate the childcare works waiting list.
  10. TANF Pre-Application Job Search: Eliminate or modify the TANF pre-application job search requirements.
  11. Minimum Wage: Increase Pennsylvania’s minimum wage from $7.25 to $9.00/hour.
  12. Gender Wage Gap: Strengthen Pennsylvania law to eliminate the 24% gender wage gap by prohibiting retaliation against employees for discussing wages (“pay secrecy”) and closing the “factor other than sex” defense to apply only to bona fide business-related factors.
  13. Family Responsibilities Employment Discrimination: Prohibit family responsibilities discrimination in employment by amending the Pennsylvania Human Relations Act to prohibit family status discrimination in employment pursuant to an expanded definition of familial status to encompass the true scope of familial responsibilities shouldered by employees.
  14. Paid Family and Sick Leave: Require all employers to provide employees with paid family and sick leave
  15. Spousal Pension Benefits: Require spousal consent when a retiring state employee chooses how his or her pension benefits should be paid consistent with federal law protecting each spouse from his or her spouse’s selection of a pension benefit in all privately-sponsored pension plans and laws adopted by other states.
  16. Domestic Worker Protection: Amend Pennsylvania anti-discrimination laws to provide domestic workers protection from employment discrimination
  17. Sexual Harassment: Extend the prohibition on sexual harassment in employment to all employers, even small employers.

    Protect Women’s Personal Safety

  18. Paid Leave for Domestic Violence, Sexual Violence, and Stalking Victims: Require employers to provide paid leave to obtain assistance for and pursue legal protection against domestic and sexual violence and stalking.
  19. Housing Discrimination: Prohibit private and public housing discrimination against domestic violence victims.
  20. Civil Orders of Protection for Sexual Violence and Stalking Victims: Authorize courts to issue civil orders of protection for sex crime and stalking victims.
  21. Absolute Privilege for Student Victims: Protect victims/witnesses of sexual assault who testify in school grievance proceedings from being sued by their harassers.
  22. Human Trafficking: Strengthen Pennsylvania’s criminal statute on human trafficking.
  23. Veterans’ Real Estate Tax Exemption: Amend Pennsylvania law to provide veterans real estate tax exemption for veterans suffering from PTSD (Post-Traumatic Stress Disorder) due to sexual victimization during service and appoint women representatives to the House and Senate Committees on Veteran Affairs and to the Pennsylvania State Veterans Commission.
  24. Voting Reform: Reform voting rules to provide online registration, same day in person registration, early voting, including early in person voting on weekends.

These ideas will be discussed in continuing meetings between members of the General Assembly’s Health Care Agenda Caucus and advocates for women’s equality.  I’ll post more on these issues as this legislative program becomes better defined.