Commentary

Supreme Court hears arguments on law regulating fake clinics (aka “crisis pregnancy centers”) today

Oral arguments in NIFLA v Becerra are being heard today at the Supreme Court of the United States. At its core, this case is about the right and duty of states to regulate the commercial speech of agencies that claim to provide health services to the general public, specifically people experiencing unplanned pregnancies. This case arose from a California law, the Reproductive FACT Act, which represented an effort to protect patients from deceptive and misleading reproductive health information as well as to prevent unnecessary delays in prenatal, abortion and contraceptive care that may happen as a result of visiting fake medical clinics that have an anti-abortion ideology.

Sometimes known as “crisis pregnancy centers” or “CPCs,” these fake clinics often advertise their services directly to women experiencing an unplanned pregnancy. By offering free services like pregnancy tests and ultrasounds, and locating themselves in low-income communities and near college campuses, these centers often target people who traditionally have had less access to affordable, quality health care. And rather than make efforts to ensure low-income communities have access to the comprehensive and quality reproductive health care they need, 14 states around the country, including in North Carolina, have diverted tax dollars to these centers that pose as medical clinics and target vulnerable communities. Many of these clinics may not have any medical professionals on staff; they often are misleading about the services they provide; and they often spread medically inaccurate information about abortion and birth control.

In the AMA Journal of Ethics, a recent article entitled “Why Crisis Pregnancy Centers are Legal but Unethical”, Drs. Bryant and Swartz outline concerns about these fake medical centers that have been a key tool of the anti-abortion movement:

“Perhaps most worrisome, regardless of whether a particular location is licensed, CPCs engage in counseling that is misleading or false [8]. Despite claims to the contrary, these centers do not meet the standard of patient-centered, quality medical care [18]. The counseling provided on abortion and contraception by CPCs falls outside accepted medical standards and guidelines for providing evidence-based information and treatment options. For example, CPCs often suggest a link between abortion and subsequent serious mental health problems [3], while multiple studies have invalidated this assertion [19-21]. Similarly, centers cite debunked literature showing an association between abortion and breast cancer [22]. Although abortion has been shown to be safer than childbirth [23], it is portrayed as a dangerous or even deadly procedure [7].”

The article concludes that “Although crisis pregnancy centers enjoy First Amendment rights protections, their propagation of misinformation should be regarded as an ethical violation that undermines women’s health.”  These fake health centers often state they don’t take insurance; and people who have adequate insurance and regular access to health care providers likely are not the people who are accessing these clinics. These fake medical centers deliberately target low-income people in part because they know that we as a society turn a blind eye to substandard care received by people who can’t afford quality care. This should not be normal, and should not be tolerated. All people deserve access to factual, medically accurate, unbiased, non-judgmental and compassionate care, no matter their zip code or their income.

Let’s hope the Supreme Court agrees.

Follow #EndTheLies and #ExposeFakeClinics on social media to learn more about this case, and these fake health centers around the country.

 

Commentary

Comment deadline is midnight tonight (Dec. 5) on Trump administration birth control rule

Tonight (at midnight) ends the public comment period for the Trump administration’s October 2017 rule that would give employers, health insurance providers and universities an opportunity to deny birth control insurance coverage for their employees and students. This new rule is in response to the Obama-era Affordable Care Act (ACA) provision that required health insurance plans to include coverage for FDA-approved-contraception methods with no co-pay for plan beneficiaries. This provision was a big benefit to people across the country who suddenly found their chosen contraception method more affordable, and therefore much more accessible.

From the introduction of this ACA provision, there was pushback from conservative forces, despite the fact that the original provision provided exceptions for religious institutions that did not believe in the practice of using birth control. For some employers the original exceptions were not enough, and they were able to get expansions of the ability to opt out of providing this benefit. And while it seemed like the balance between religious liberty and access to medical care had been achieved, the Trump administration, in an apparent concession to very conservative special interest groups, issued the October rule (effective immediately) that expanded the number of institutions that could claim a “religious or moral” exception to providing birth control coverage to its employees, and therefore drop it.

The Obama-era provision was a popular one in particular with low-income and young people who need to access contraception for both pregnancy prevention and other medical needs. This ruling that in effect makes it optional for many employers to offer the coverage at all has the potential to adversely impact the health and lives of many people, and can be seen as legitimizing discrimination, rather than preserving religious liberty. Despite what some suggest, this original provision is not offering “free contraception” to employees or students. All employer/university-sponsored insurance is provided in exchange for labor and/or cost-sharing (including paying partial premium costs, or tuition costs). Denying those entering into that deal the full range of benefits simply because they have uterus/ovaries is discriminatory, and will result in higher health care costs for this group.

The current Administration has suggested that this expansion of the exceptions to providing this coverage likely won’t impact that many people. Read more