|
Sexual
and Reproductive Health Issues in the States:
Major
Trends in 2005
State legislatures paid
particular attention to sexual and reproductive health policy issues
in 2005. A total of 98 new laws were enacted, just over half of
which are aimed at restricting access to abortion while a quarter
seek to expand access to contraception. Moreover, of the 195 abortion
restrictions adopted in the six legislative years beginning in 2000,
fully one-quarter were enacted in 2005 alone. Similarly, of the
83 measures enacted since 2000 to promote contraceptive access,
one-quarter were adopted last year.
For a state-by-state overview
of legislation enacted in 2005, click
here.
Trends
in Abortion Legislation
Anticipating
a U.S. Supreme Court less supportive of abortion rights than in
the past, South Dakota last year adopted legislation
that would immediately criminalize abortion in the state should
Roe v. Wade be overturned. In doing so, it became the
fourth state with such a provision on the books, joining Illinois,
Kentucky and Louisiana.
The year
also saw extensive legislating in the area of parental involvement
in a minor's abortion. Arkansas and Texas
replaced existing parental notification statutes with
new laws mandating parental consent, while Idaho
enacted a new consent provision to replace one previously enjoined.
(The Idaho provision was immediately enjoined and is not in effect.)
New parental notification mandates were enacted in Florida
and Oklahoma , while Georgia
and South Dakota modified existing provisions
to make them more stringent. And Missouri took
a new tack, moving to prohibit helping a minor to cross state lines
in order to circumvent the state's parental notice requirement.
On the other side of the coin, California voters
defeated a special-election ballot initiative to require parental
notification by amending the state's constitution. Currently, 34
states mandate parental involvement in a minor's decision to have
an abortion, with 21 requiring consent and 13 requiring notification.
Meanwhile,
antiabortion legislators continued their attempts to require that
women obtaining an abortion be given specific information under
the aegis of “informed consent,” many times including information
that cannot be scientifically supported. In 2005 alone, 73 such
mandatory counseling measures were introduced, and laws were enacted
in seven states ( Arkansas , Georgia , Indiana , Louisiana
, Minnesota , Oklahoma and South Dakota ).
The new laws in Arkansas, Georgia and Minnesota require that women
be told that a fetus may be able to feel pain (and that they be
offered the option of having anesthesia administered directly to
the fetus), even though there is no scientific evidence to support
this statement; these provisions are similar to an existing law
in Illinois. Indiana joined Arkansas in requiring that women seeking
an abortion be told of the availability of ultrasound imaging and
given an opportunity to view ultrasound images before obtaining
the procedure. And a new South Dakota measure requires that a woman
seeking an abortion be told that "abortion will terminate the
life of a whole, separate, unique, living human being" and
that she has an "existing relationship" with the fetus
that "enjoys protection under the United States Constitution."
That law's constitutionality was challenged immediately, and the
measure was enjoined by a federal district court in June.
Finally,
antiabortion efforts continued last year to deprive certain types
of organizations of state funds while rewarding others. Ohio
, Pennsylvania and Texas
moved to continue existing policies that, in the allocation of state
family planning funds, disadvantage Planned Parenthood and other
local agencies that provide abortion-related services, including
referral. These states and five others ( Florida ,
Kansas , Minnesota ,
Missouri and North Dakota) also adopted or extended legislation
authorizing funding for organizations that provide counseling on
"alternatives to abortion" and services to pregnant women.
Along the same lines, Ohio sanctioned the sale
of "Choose Life" license plates, with the proceeds going
to fund nonprofit organizations
that encourage pregnant woman to choose adoption, bringing to 12
the number of states using this strategy to fund abortion
alternatives.
While most
states that took action on abortion issues did so to restrict access
to services, Montana was alone in 2005 in moving
to protect access to abortion clinics by creating a protected zone
around clinic entrances. A total of 15 states and the District of
Columbia now have policies aimed at protecting access to clinics.
Promoting Access
to Contraception
Interest
in expanding eligibility for Medicaid-funded family planning services
intensified in 2005. Legislatures in Connecticut ,
Indiana , Massachusetts and Texas
adopted measures directing the state to apply for federal
permission to establish an expansion program. Under the Connecticut
, Massachusetts and Texas programs, coverage would be extended to
state residents with an income up to or close to 200% of the federal
poverty line; the Indiana program would be more limited, only extending
the period of time a woman remains eligible for family planning
following a Medicaid-funded delivery. Currently, 21 states have
a federally approved expansion program in place.
[Last year
was the first, however, in which legislatures moved to restrict
their expansion programs. The measure adopted in Connecticut would
limit the state's expansion to adults. Indiana 's would implicitly
exclude coverage for emergency contraception, even though emergency
contraception is covered for other Medicaid recipients. The Texas
legislation is quite restrictive: It contains both of the above
provisions, requires that contraceptive counseling emphasize sexual
abstinence for unmarried women and bars participation in the program
by any family planning provider that also provides abortion-related
services with other funding.]
Two states
in 2005, Arkansas and West Virginia ,
adopted laws requiring that private insurance plans in the state
include coverage of contraceptives if they cover other prescription
drugs. (An additional measure passed the New Jersey
legislature in 2005, but it was not signed into law until January
2006.) The West Virginia law applies to adults but not to minor
dependents, the first time a state has made such a distinction in
the context of a contraceptive coverage mandate. The Arkansas measure,
meanwhile, excludes coverage of emergency contraception (as does
an existing law in North Carolina). Both laws contain relatively
narrow exemptions that permit religious employers to refuse to provide
contraceptive coverage for their employees. To date (including New
Jersey), 24 states now have a contraceptive coverage insurance mandate.
Massachusetts
and New Hampshire (the former, by overriding
the veto of Gov. Mitt Romney [R]) last year enacted laws permitting
pharmacists to dispense emergency contraceptives without a prescription;
a total of eight states now have such policies. Meanwhile, Massachusetts
(also through the veto override) and New Jersey
moved to require hospital emergency rooms to dispense
emergency contraceptives to sexual assault victims on request, while
Texas enacted a measure requiring that sexual assault
victims be given information on STD treatment and pregnancy prevention
methods, presumably included emergency contraceptives. These new
laws bring to nine the number of states requiring that women who
have been sexually assaulted receive at least some services related
to emergency contraception.
Two states
last year took steps to limit the ability of pharmacists to refuse
to fill physicians' prescriptions for contraceptives, including
emergency contraceptives. California Gov. Arnold
Schwarzenegger (R) signed legislation requiring pharmacists to fill
valid prescriptions. Under the measure, a pharmacy that permits
an individual pharmacist to refuse to fill a prescription must ensure
that patients can access their medication in a timely manner. Meanwhile,
Illinois Gov. Rod Blagojevich (D) promulgated
regulations requiring pharmacies that stock any contraceptive to
dispense all methods, including emergency contraceptives.
Finally,
two governors vetoed legislation designed to expand the ability
of pharmacists to refuse. Arizona Gov. Janet Napolitano
(D) vetoed a bill that would have expanded the state's existing
refusal policy by allowing health care institutions, including pharmacies
and individual medical providers, to refuse to provide services
related to abortion or emergency contraception. And Gov. Jim Doyle
(D) vetoed a measure that would have allowed pharmacists in Wisconsin
to refuse to provide either abortion or contraceptive
services.
Other Notable
Trends
This past
year also saw the emergence of stem cell research as a major topic
of concern to the states, with six states taking supportive action
and a restrictive measure being vetoed in one. Arizona and Hawaii
commissioned fact-finding panels to analyze the costs and benefits
to the state of establishing stem cell research programs. Connecticut
, Indiana , Massachusetts and Virginia moved to actually fund stem
cell research; all of these states except Indiana simultaneously
acted to ban human reproductive cloning. Finally, the governor of
Wisconsin vetoed legislation that would have banned all cloning,
therapeutic and reproductive, in the state.
Appropriate
penalties for assaults on pregnant women also remained an area of
interest, with seven states enacting new or amended laws. Six— Arizona
, Florida , Maryland , Oklahoma , South Dakota and West Virginia
—enacted measures creating an independent penalty for fetal homicide
or assault. Maine , meanwhile, enacted two laws, one to increase
penalties for assault of a pregnant woman and the other to better
monitor domestic abuse involving pregnant women.
Finally,
interest in using ballot initiatives to make reproductive health
policy—as seen in both Florida's successful abortion parental notification
effort in 2004 and California's unsuccessful effort last year—appears
likely to continue. In Florida, Missouri and New Jersey , advocates
are already pushing for supportive stem cell research initiatives.
Signatures are being collected to put an initiative to establish
personhood at conception on the ballot in Michigan . And in Oregon
, advocates are working to add two initiatives to the November ballot,
one that would require parental notification for abortion and the
other to consider a fetus a victim in the homicide statutes.
Production
of the State Update is made possible by support from The David and
Lucile Packard Foundation.
Return to the Top
|
|
