September 2019 Legislative News

There has never been a more important time to in women’s health to be vocal advocates for our patients and our field. In District I and around the country, we are seeing legislation that protects and expands access to reproductive health, establishes maternal mortality review committees, and ensure women continue to have full access to contraception regardless of federal policy changes. We are also seeing significant legislative threats that affect how our patients access health care and how we as ob-gyns can provide that care.

Our members are using their voice to advocate for change—and that’s more important now than ever. From op-eds to testifying at the statehouse to helping to champion critical legislation, District I Junior Fellows and Fellows are making their voices heard.

The importance of advocacy in our field was highlighted by the largest Congressional Leadership Conference (CLC) ever held with more than 700 ob-gyns from all 50 states this past March in Washington, DC. District I also set a record in attendance.

We met with key policy makers to discuss two main issues: ending preventable maternal deaths and protecting the Affordable Care Act’s landmark women’s health protections, including coverage for preexisting conditions.

These issues continue to be fought on a national and state level. Consider joining us at the 2020 CLC, to take place March 8–10 in Washington, DC. Take this opportunity advocate for patient care beyond the exam room. CME credits are also available.

Addressing Rising Rates of Maternal Mortality

Last year, ACOG and its members scored a legislative win by getting the Preventing Maternal Deaths Act enacted into law. However, our work is far from over. This year, the focus was on several bills aimed at reducing the rising rates of maternal mortality, aptly called a Momnibus. These bills support and expand the Alliance for Innovation on Maternal Health, support state-based perinatal quality collaboratives, support extending Medicaid coverage to 12 months postpartum, and include efforts to reduce racial and ethnic disparities through implicit bias training. There are numerous bills supporting these efforts in the House and Senate. It’s important that we keep the momentum going on these important efforts and contact our representatives to support these legislative efforts.

Protecting the Affordable Care Act

The Affordable Care Act offered important protections for women’s health. Insurers could no longer deny coverage to women with preexisting conditions or charge higher premiums for women and were required to cover maternity care.

However, in 2018, the Trump administration allowed for short-term, limited duration insurance plans to be used more broadly. Previously, these plans could only be used as bridge insurance plans for up to three months, but these new regulations allow these “junk-insurance” plans to be used for up to three years. These plans can deny coverage for patients with preexisting conditions and do not cover maternity care. Additionally, the administration allowed for insurance plans for small employers and self-employed individuals that do not cover maternity care or have other essential benefits. Essentially, these plans provide our patients with insurance, but not coverage for essential benefits such as maternity care. During the CLC, ACOG members advocated for several bills that protect patients with preexisting conditions and require the short duration insurance plans to remain at three-month coverage. C

Threats to Title X

In March of 2019, the Trump administration finalized a regulation that blocks the availability of Title X funding for family planning providers and imposes restrictions on medical care they can provide. Under this regulation, sites that participate in Title X are prohibited from referring patients to abortion providers or offering abortion services within their non-directive pregnancy options. If a patient requests information about obtaining an abortion, the provider can give the patient a list of providers, all of whom provided prenatal care but only some of whom provided abortion care. However, the provider is prohibited from disclosing which of the clinicians on the list provide abortions. Additionally, if a clinic or facility provides abortions, they would be ineligible from receiving Title X funding. This targeted organizations such as Planned Parenthood.

After the rules went into effect in early 2019, several judges blocked the rules from going into effect prior to the proposed May start date. These blocks were overruled and now the Trump administration plans to enforce these rules for Title X grant recipients. Legal challenges to these changes are likely to continue.

ACOG has denounced these efforts by the Trump administration to prevent nearly 4 million women with low income from accessing important reproductive health care services. Read ACOG’s statement on the new Title X ruling.

Threats to Abortion Access

In 2019, we have seen a surge in anti-abortion legislation across the country. In District I, abortion restrictions or abortion bans have been introduced but none have been signed into law. However, Alabama enacted a total ban on abortion, Ohio, Georgia, Kentucky, and Mississippi enacted a six-week abortion ban, and Missouri has enacted an 8-week abortion ban. In some states, there is no exception for abortion in cases of rape and incest. All of these laws have been legally challenged and have not gone into effect. ACOG is watching these laws closely and recognizes that access to safe and legal abortions is an essential component of women’s health care.

Ongoing Legislative Efforts

• Legislation to protect a women’s reproductive choice at the state level
• Scope of practice for our midwife colleagues, including lay midwives
• Continuing efforts to combat the opioid epidemic

ACOG and our members’ involvement on all of these issues and more cannot be underestimated. It is vitally important that we use our voice to advocate for our patients and our field in the exam room, in the hospital, in our communities, and at the state and federal levels. Your District I legislative team is here to support you. If you want to get more involved with your state’s legislative issues, please contact me at [email protected] to help connect you with your legislative representative. Also, if you wrote an op-ed, letter to the editor, or testified on a bill, please let us know so we can spread the word and celebrate your advocacy efforts.