Legislation

October 1, 2013

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.

June 25, 2013

War on Women in Pennsylvania: At Least a 20-Year Happening

Last week, Governor Tom “Just Close Your Eyes” Corbett signed into law Act 13 of 2013, also known as HB 818.  This newest attack in the War on Women denies women the ability to use THEIR OWN FUNDS to purchase coverage for an abortion within the new healthcare exchange that Corbett decided to fob off onto the federal government.  Although the state couldn’t be “bothered” with running this exchange, they have no problem in denying women the ability to purchase coverage for an abortion even in cases in which her life is endangered.

At the time of final passage of the bill I sent out an email to several friends listservs. Here are some of the comments I received back:

What is going on in PA?  It’s beginning to sound more & more like a North Dakota or a Kansas [or a Mississippi or an Arizona or a Wisconsin or a Texas or any other state that’s been taken over by misogynists and racists].  Terrible!!

If women aren’t allowed to spend money on their healthcare the way they deem medically necessary, then it’s time to face the fact that we’re not even citizens in our own states.

I agree with all of these sentiments.  Yet, these types of legislative actions have been going on in Pennsylvania for a long time, despite Pennsylvania having an ERA in our state Constitution and having already ratified the national ERA.

Bit of history of the War on Women in Pennsylvania.  We’ve been battling this War for over two decades in our legislature.  The battles started with attacks on reproductive justice and have now spread to other areas of women’s lives.

Reproductive Justice Battles

The Pennsylvania General Assembly has basically been co-opted by the radical right-wing on both sides of the aisle.  The Democrats do have more pro-choice people than the Republicans.  The Senate is a bit better than the House of Representatives.  And this has basically been true since the late 1980’s.

  1. Which is why Governor Bob Casey, Sr. (D) pushed through Pennsylvania’s Abortion Control Act that initially mandated parental consent, spousal consent, a 24-hour waiting period, and a state-mandated script about the “detriments” to health in abortion procedures.  Planned Parenthood contested the law that went all the way to the US Supreme Court in a case called Planned Parenthood of Southeastern Pennsylvania v. Casey. Decided on June 29, 1992, the Court threw out spousal consent as an “undue burden,” but upheld the rest of the law. This was one of the first battles partially won by the emerging War on women.  That was 21 years ago this week.
  2. Which is why Title X and state Family Planning monies are split 50/50 each year in the state budget between crisis pregnancy centers and legitimate family planning clinics.  And this has been happening for over a decade now. And in 2012, Rep. Daryl Metcalfe (R) proposed eliminating ALL funding for family planning for Planned Parenthood or any other clinic that provides abortion services.
  3. Which is why we are losing stand-alone abortion providers due to the TRAP (Targeted Regulations on Abortion Providers) law passed in December 2011 following “Dr.” Gosnell’s arrest and guilty verdict for murdering 9 live-born infants and one woman in a filthy, rat-infested facility that the state had not inspected despite complaints from legitimate providers for about 10 years.
  4. Which is why we almost had a transvaginal ultrasound law last year.  And for Governor Corbett’s “Just close your eyes” statement (Corbett’s comments on the ultrasound bill start at 14:28).  The main reasons I think it ultimately died in committee is thanks to the activists in VA who created the uproar there and because so many people, including doctors were outraged by the invasiveness of this bill and for Corbett’s insensitive statement (of which he is becoming more or more well-known for – he’s his own worst enemy).

Other Battles in the War on Women in Pennsylvania

And on other issues – similar actions have occurred.

Increasing Conservatism in the Legislature and Governorship

In 2010, the Tea Party and the radical right swept into office an even more anti-woman legislature and governor here in Pennsylvania.  The War on Women went into full swing.  Both houses of the General Assembly became even more heavily conservative, with the House switching from a Democratic- to a Republican-controlled majority and the state elected an anti-choice, anti-woman, and in my opinion, racist governor – Governor Tom Corbett (R).

To highlight how conservative the Pennsylvania General Assembly has become, just look at the 2012 ratings of legislators by the American Conservative Union.  They indicated that 51% of members in the combined Assembly are solid conservatives; 105 or 42% are given a score of 100 and an additional 22 or 9% are rated at 63 or higher.  The entire leadership of the majority party in both houses and thus those with the power to deny women, people of color, people with disabilities and people living in poverty their basic rights are listed in their report as so-called “Defenders of Liberty” or “Conservatives” because of their rating of, respectively, either 100 (13 of the 16 leaders) or 80 (the remaining 3 leaders).

Attack on Hate Crimes Protections

An updated hate crimes bill was initially passed in 2002 that added gender, gender identity, national origin, disability, and sexual orientation.  Because the radical right didn’t want to vote against adding sexual orientation coupled with disability and gender and thereby anger multiple constituencies within their district, a member of the House, proposed a late-night, end of session amendment in the 2001-2002 legislative session that substituted the hate crimes bill for an agricultural crimes bill.  The vote was overwhelmingly in favor, mostly because the legislators didn’t want to appear to be supporting hate crimes via a no vote (prior to this the then Republican majority had refused to bring up the bill for a committee vote). The radical right-wing appealed saying that this substitution violated the state’s constitutional mandate that any amendment has to be germane to the original intent of the bill.

The Pennsylvania Supreme Court agreed in July 23, 2008 that this procedure (but not the underlying intent) was unconstitutional and threw out the law.  It has been reintroduced every session since then with no hearing or vote in any committee in either house.

Attacks on Marriage Equality

In addition to having a state-based mini-DOMA (a state-level Defense of Marriage Act) on the books, Pennsylvania has had several attempts at adding this form of discrimination to our state constitution introduced every session for the last decade.  The major reasons they have not passed is that the House is even more conservative than the Senate and the two houses can’t agree on how extreme to make it.  There is another one that has been introduced in the General Assembly this year, but due to increasing support by the public for civil unions and marriage equality (almost 2/3 support throughout the state), they haven’t yet held any hearings.

Budgetary Attacks

One of the spears attacking women, families, and people of color since the takeover of our legislative and executive branches of government here in the state is the budget.

We have had severe cutbacks in state funding for education, health care, and human services since 2011.  According to the Pennsylvania Budget and Policy Center, spending on these three areas in the final budget for 2012-2013 that ends this week was either flat-lined (“welfare” programs) or reduced by 0.3% (for public school education), 15.9% (for higher education), and 37% to 45% (for Medical Assistance inpatient and outpatient care).

The proposed budget plan for 2013-2014 continues these cuts. Here are a couple of examples of this budgetary war:

Attacks to Eliminate Equality for All

In the very first budget introduced by Governor Corbett, every advocacy Commission in the Executive branch was eliminated in the 2011-2012 budget – this includes the Pennsylvania Commission for Women (which I served on until it was abolished), Latino Affairs, Asian-American Affairs, and African-American Affairs.  As you will see from the links to these commissions, there is no public information on who the commissioners are nor is the any information on the services any of these commissions provide.  Prior to the elimination of these commissions in 2011, the Commission for Women, for example, had an extensive web presence which included our mission (the only thing that now remains), hotline contact information, copies of reports written by the Commission, information on the advocacy being conducted by the Commission, and links to programs and services to broadly assist women.  Transparency has disappeared; this is another spear in the attacks with the War on Women here in Pennsylvania.

Like every other state, Pennsylvania has a commission that monitors, reviews and adjudicates alleged acts of discrimination; here in Pennsylvania that is the Pennsylvania Human Relations Commission (PHRC). Severe budgetary cut-backs have occurred in the funding for the PHRC in every budgetary cycle since 2011.  An individual who works within the PHRC told me last month that as a result of these cuts, they are down 50% in staffing and that long-time civil rights advocates in the agency have either retired (some early) or left for other work.  And it’s not getting any better. The PHRC is flat-lined in this year’s budget.  We don’t yet know if this will still be true once the budget is passed, which theoretically must be done this week since our state constitution requires passage by June 30 of each year.

Gerrymandering

Gerrymandering is part of the War on Women due to its impact on legislation directly affecting women’s lives. Gerrymandering here in Pennsylvania, aka the “Gerrymander of the Decade,” has entrenched the right-wing Republicans in both the General Assembly and the Pennsylvania Congressional delegation.  This, despite the fact that there are many more registered Democrats than Republicans in the state.

Being a Democratic legislator, as we all know doesn’t guarantee concern for women’s rights (think Senator Bob Casey, Jr. and his father, former Governor Bob Casey, Sr.). But in these days and times, it’s less likely to cause a problem for us than do the Tea-Party dominated Republicans.

The most recent vote in the General Assembly is a clear example of what gerrymandering has done to the legislature.

Gerrymandering, combined with the elections resulted in the passage of HB 818/Act 13 this month. Tea Party Republican conservatives won many of their races in 2010 and 2012, taking control and leadership of both houses in 2011.  In the House there are 111 Republicans and 92 Democrats.  On April 24, 2013, all but 2 Republicans (98%) voted against and all but 32 Democrats (65%) voted for women’s reproductive justice. In the Senate there are 28 Republicans and 22 Democrats. On June 5, 2013, all but 2 Republicans (93%) voted against and all but 5 Democrats (77%) voted for women’s reproductive justice.

State and Federal ERA

Another comment that was made when I sent out my email was about passing the federal Equal Rights Amendment (ERA). The person said,

This is the reason we need to be included in the Constitution of the United States!  One of main ways to stop bills like this is to pass the ERA and thus be admitted as full-fledged citizens of the US.

Before the War on Women started, Pennsylvania passed a state-based ERA that was voted on by the electorate and placed into Section I of the Pennsylvania Constitution in 1971.

Yet even with this state-based ERA, the War on Women is being raged here in Pennsylvania.  Sometimes the state ERA works and sometimes it doesn’t.  It worked back in the 1980’s when Pat and Twiss Butler worked with Pennsylvania NOW to get gender-based auto insurance rates eliminated.  But it didn’t work in 2008 when a woman sued her employer using the state ERA based on sexually offensive comments made by her supervisor but not stopped by the company.

Many people, in frustration have made statements or created nicknames to replace the official monikers of “City or State of Brotherly Love” and the “Cradle of Independence.”  A couple of the pejoratives include “Pennsyltuky” and “Philadelphia and Pittsburgh with Alabama in the middle” (this latter one is attributed to James Carville)  The progressive parts of the state (for the citizenry, but not necessarily the full legislature) are currently Philadelphia and SE PA, the capital Harrisburg (to some minor extent) and Centre County where I live.  Pittsburgh is still itself progressive, but Allegheny County (where Pittsburgh is located) has become very, very conservative and thus more like the “T” (the term used to describe the rural part of the state outside of the Pittsburgh and Philadelphia regions).

Yes, it is frustrating.  But as a “cock-eyed optimist” (something I’ve often been called), I continue to push back and sometimes we get things that are a bit better than they would have been otherwise.  Much of our work is being done in coalition these days.  I won’t stop my push-back against this War on Women.  I will continue my multi-decade work and will continue to shout from the mountain top whenever and wherever needed.  As will others (see for example, an article in Politico about the War on Women battle for the Pennsylvania governorship gearing up here in Pennsylvania).

Be a “cock-eyed” optimist.  Get the ERA passed and stop this state and national War on Women. As Margaret Mead said,

Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.