The courts have allowed the gag rule to go into effect immediately in every state except Maryland. This gag rule makes it illegal for health care providers who receive funding from the Title X Program to refer patients for abortion. With this ruling, the health and lives of approximately 4 million low income women nationwide is at risk.
Maryland passed “Family Planning Program Funding” legislation that prohibits providers from accepting Title X funding if it excludes family planning providers and does not require providers to provide “a broad range of acceptable and effective medically approved family planning methods and services”. If the funding is not available, the Governor is required to fund the Family Planning Program.
Maternal Mortality Review Committees (MMRC) are now functional in every Section in District IV. The MMRC in the District of Columbia has had its first two meetings. In Maryland, legislation has passed that allows Baltimore City to have a local MMRC while the state MMRC continues to function with a legislatively mandated focus on social determinants of health, including data on racial disparities. In Georgia, legislation was passed to establish the House Study Committee on Maternal Mortality which will include two members of the existing MMRC. The Georgia legislature also has provided funding for nursing abstractors for the MMRC.
A focus for many state legislatures in the last legislative session was the restriction of abortion. In South Carolina, ACOG officers and members worked with state Senators and Representatives to prevent legislation from passing that would have banned abortion. Amy Crockett, South Carolina Fellow Legislative Chair, applied for and received funding from the Ob/Gyn PAC for a reception and funding for those members of the legislature who were opposed to the legislation. It is anticipated that the previously defeated legislation will be re-introduced in the next legislative session. The South Carolina ACOG legislative advocates expect continued support from the members of the legislature who were opposed to the legislation in the previous session.
In the last legislative session in Georgia, Governor Brian Kemp pushed the “Fetal Heart Bill” through the General Assembly, He then signed it into law in May, 2019 with the bill scheduled to take effect on January 1,2020. The bill prohibits abortion after the detection of fetal heart tones with a few exceptions. The bill criminalizes physician care. The Georgia Section/GOGS opposed the bill and many ob/gyns testified against it. Other physician associations joined the ob-gyns in opposition to this legislation. Members of the movie industry have threatened to remove Georgia as one of their filming sites if this legislation is not reversed. The ACLU has submitted a lawsuit against this legislation.
The Georgia ob-gyns did have success with funding for every ob-gyn resident in Georgia, the passage of an anti-shackling bill and funding for a Maternal Tele Psychiatry program.
In North Carolina, the birth center license bill overwhelmingly passed the House and is pending approval in the Senate. The bill includes all of the NC ACOG priorities. The House has not passed the Medicaid expansion bill which is part of the stalemate over the budget. There is concern that this stalemate may continue into the fall which will prevent millions of dollars in non-recurring funding from being dispersed.
In both Maryland and DC, prescription contraception is now legislatively mandated to be available for 12 months at a time.
The DC Junior Fellows are working with members of the DC City Council to extend Medicaid eligibility for one year postpartum, a marked increase from the current 60 days.
To get involved, contact the District IV Fellow or Junior Fellow legislative chairs or contact your state legislative chair. Another option is to go to www.acog.org/advocacy to become an advocate. If you are on social media, join the conversation by following @ACOGaction.
Constance Bohon, MD, FACOG
Holly Puritz, MD, FACOG
ACOG District IV Legislative Chairs