Rep. Senfronia Thompson (second from left) and other Texas representatives hold coat hangers while discussing HB2, an anti-abortion bill.
Ever since Texas passed HB2 in 2013, the omnibus abortion law at the heart of a pivotal case the Supreme Court will review early next year, more than half of the state's 41 abortion clinics have been forced to close. As these closures have mounted, advocates in the state have worried that the decline in abortion access could lead to a rise in the number of women trying to terminate pregnancies by themselves.
A new studyquantifies some of those fears: At least 100,000 Texas women—and as many as 240,000—between the ages of 18 and 49 have attempted to self-induce abortions, according to a report released today by the Texas Policy Evaluation Project (TxPEP). The study also found that it is possible that the rate of women attempting to self-induce abortions is rising in Texas as a result of the state's additional restrictions on abortion care. The report points to previous studies that have explored the correlation between a rise in abortion restrictions and the prevalence of self-induced abortions. A 2008 national study found that about 2 percent of women reported that they tried to terminate pregnancies on their own. In 2012, a year after Texas passed several new abortion restrictions, a study of Texas women seeking care at an abortion clinic found that about 7 percent reported attempting to end their pregnancies without medical assistance before seeking clinic care.
"This is the latest body of evidence demonstrating the negative implications of laws like HB2 that pretend to protect women but in reality place them, and particularly women of color and economically disadvantaged women, at significant risk," said Dr. Daniel Grossman, one of the study's co-authors and a professor in the department of obstetrics, gynecology, and reproductive sciences at the University of California-San Francisco, in a press call Tuesday morning.
Amy Hagstrom Miller, the president and CEO of Whole Woman's Health, an independent abortion provider in Texas and the lead plaintiff in the HB2 case currently before the Supreme Court, reiterated that Texas has seen a rise in self-induced abortions since abortion restrictions like HB2, and that terminating a pregnancy with DIY methods is not healthy for women. "Nobody should be denied safe and compassionate care based on her zip code," said Hagstrom Miller. "But that's exactly what's been happening.
These findings come from a survey of nearly 800 women, ages 18 to 49, conducted by TxPEP over two months in 2014 and 2015. The women were asked if they knew or suspected that their best friend had ever self-induced an abortion, and if they'd ever done so themselves. Overall, 1.7 percent of respondents said they had tried to self-induce an abortion, while 4.1 percent of women said they knew or suspected their best friend had done so. Applying these proportions to the nearly 6 million women of reproductive age in Texas, the researchers concluded that an estimated 100,000 to 240,000 Texas women ages 18-49 have attempted to end a pregnancy alone.
The study identifies two populations where histories of self-induced abortion were most prevalent: Latina women living in a county that borders Mexico—a more rural area of the state that has seen several clinic closures—and women who reported difficulty gaining access to reproductive health care in the past.
The study also determined that the two broad categories of methods used by women to end their pregnancies were home remedies such as herbs, teas, vitamins, or medications—primarily misoprostol—obtained in Mexico without a prescription by women traveling there.
Typically, a medication abortion in the United States requires that two drugs—misoprostol and mifepristone—be taken about 24 hours apart. But most doctors say misoprostol alone can be an effective way to induce an abortion if the combined regimen is not available. Most of the women who reported obtaining misoprostol had a complete abortion after using the drug, but used different doses and methods of administration. Many reported intense symptoms throughout the abortion—intense cramping and bleeding, for instance—and some talked about being unsure whether these symptoms were normal or healthy.
Most women cited one or more of four reasons for choosing to self-induce: They lacked the money to travel and/or pay for the procedure; their local clinic had closed; a close friend or family member had recommended self-induction; or the women feared the stigma associated with going to an abortion clinic.
But Grossman pointed out that among these specific reasons, "a common layer was that poverty layered on one or more of these obstacles led women to self-induce."
Anti-abortion activists rally on the steps of the Texas capitol in July 2015.
Since this summer's release of doctored sting videos targeting Planned Parenthood, Congress has been embroiled in a fiery debate over funding for the women's health care provider. On Monday, the Supreme Court made clear that it wants nothing to do with this fight. The court declined to hear a case involving federal funds for Planned Parenthood and the organization's privacy in the face of continued probes by anti-abortion activists.
The case, New Hampshire Right to Life v. Department of Health and Human Services, centered on a 2011 public records request filed by New Hampshire Right to Life, an anti-abortion group,with the US Department of Health and Human Services, asking for documents filed by Planned Parenthood when applying for federal funding. The women's health provider had historically received federal funds for family planning services through New Hampshire's state government. But in 2011, the state administration decided to stop accepting and distributing this federal money, concerned that it was being used to "subsidize abortions."
To fill the gap in Planned Parenthood's funding, HHS decided to provide funds to the group directly for 16 months. It required the group to file documentation about its internal policies—including its medical standards manual and its fee schedule—in order to receive the funds, which Planned Parenthood did.
New Hampshire Right to Life filed its request to HHS under the Freedom of Information Act, asking for access to these Planned Parenthood filings and to internal HHS memos tied to the department's decision to provide the reproductive health provider with a federal grant. When HHS refused, New Hampshire Right to Life sued the agency for the documents. HHS ultimately turned over about 2,500 pages of internal agency records. But it withheld most of the Planned Parenthood filings and some internal documents, primarily citing FOIA's Exemption 4, a portion of the law that exempts certain types of commercial information filed by private groups from disclosure.
A federal district court and circuit court both upheld HHS' refusal. Now that the Supreme Court has refused to wade into the disclosure debate, it's cemented that refusal as final.
Attorneys for New Hampshire Right to Life painted the court's decision not to hear the case as another example of government favoritism in the ongoing battle over public funds for Planned Parenthood. "We had hoped the US Supreme Court would consider this case," said attorney Michael Tierney in a statement, "which would have addressed whether the government can continue to veil its support for Planned Parenthood."
On Friday, the Supreme Court announced that it will hear its first abortion case in nine years. At issue in Whole Woman's Health v. Cole is HB 2, an omnibus Texas abortion law that made national headlines in 2013 after Texas Sen. Wendy Davis spent 11-hours filibustering the bill that eventually passed anyway.
Since 1992, the court has ruled on three abortion cases, each time affirming further abortion restrictions. In 1992, in Planned Parenthood v. Casey, a divided court upheld the right to abortion, but left it to the states to set abortion restrictions, saying that these regulations can't put an "undue burden" on abortion access. This broad ruling opened the door for the hundreds of so-called Targeted Regulation of Abortion Providers or TRAP laws that states have passed in recent years—onerous regulations placed on abortion providers, often purporting to protect women's health. In its last ruling in 2007, the court upheld a law outlawing dilation-and-extraction second-trimester abortions. If the court continues its pattern of voting against abortion rights and rules to allow Texas to move forward with several burdensome abortion restrictions, it will open the door for other states to do the same, dealing a serious blow to the right to legal abortion guaranteed by Roe v. Wade.
"The Court now has the opportunity to decide whether we will continue to allow elected officials to play politics with women's health."
"The Court now has the opportunity to decide whether we will continue to allow elected officials to play politics with women's health," wrote Ilyse Hogue, the president of NARAL Pro-Choice America, in a statement. "This case represents the greatest threat to women's reproductive freedom since the Supreme Court decided Roe vs. Wade over 40 years ago. Laws like the ones being challenged in Texas are designed to subvert the Constitution and end the right to a safe and legal abortion."
In this case, the justices are expected to focus on two of the Texas law's most onerous requirements: that abortions be performed in ambulatory surgical centers, hospital-like facilities that specialize in outpatient surgery, and the requirement that abortion providers obtain admitting privileges at a nearby hospital. Many medical professionals argue that these restrictions put unnecessary burdens on abortion providers: Building and maintaining an ASC is expensive, given the strict requirements regarding features like hallway width and ventilation. Nor do ASCs enhance the standard of care for abortion; the American College of Obstetricians and Gynecologists and other medical groups have repeatedlynoted that the procedure can be safely performed in a typical doctor's office. The admitting privileges' provision gives hospitals in conservative communities or with a religious affiliation the power to effectively stop abortions by denying the necessary admission privileges to doctors.
"The common-sense measures Texas has put in place elevate the standard of care and protect the health of Texas women," wrote Texas Attorney General Ken Paxton in a statement released following Friday's Supreme Court's announcement. "We look forward to demonstrating the validity of these important health and safety requirements in Court."
The number of abortion clinics inTexas has already been cut by more than half, as elements of HB 2,such as restrictions on medication abortion, a 20 week abortion ban, and the admitting privileges requirement, have gone into effect over the last two years. Before the law, there were 41 clinics in Texas. Today, there are 18. As my colleague Molly Redden reported in September, this has created large swathes of the state where women must travel hundreds of miles to get abortion care. If the Supreme Court upholds HB2 in full, including the ambulatory surgical center requirement, the number of abortion clinics in Texas could fall to ten.
The Supreme Court has intervened on HB 2 twice before. In October 2014, the court reinstated a district court's ruling that blocked the ambulatory surgical center provisions of HB2 from going into effect and triggering more clinic closures while the Fifth Circuit court considered the case. At that time the high court also overturned the admitting privileges requirement for two Texas facilities. In June 2015, after the Fifth Circuit ruled to allow the HB2 provisions to go forward, the Supreme Court put an emergency stay on these requirements, to remain in effect while the court decided whether to take on Whole Woman's Health for a full review.
Planned Parenthood and other abortion providers in Texas have been preparing to comply with HB2's new requirements since mid-2014, when the law was originally slated to go into effect. Planned Parenthood, for instance, has spent millions to build or refurbish several ambulatory surgical centers in the state. Mother Jonestraveled to Texas to observe these preparations for HB2. Check out our video footage below. (Some of the video numbers have since changed slightly.)
The court has not yet announced whether it will also take Jackson Women's Health Organization v. Currier, a case that centers on a Mississippi law that requires abortion providers to obtain admitting privileges at a nearby hospital, but given that they've taken the Texas case, it is unlikely. Mississippi currently has only one abortion clinic, and its abortion providers are board-certified OB-GYNs. But because hospitals in the area have been unwilling to grant—or sometimes even process—the doctors' applications for admitting privileges, if this law stands, it will close down Mississippi's last abortion clinic. In July 2014, the fifth circuit court of appeals ruled that the law was unconstitutional, upholding a lower court's ruling.
A decision in the Texas case will come down in the first half of 2016, likely making reproductive rights a central issue in the presidential election. "Although this is the first step in a much longer process," said Amy Hagstrom-Miller, the president and CEO of Whole Woman's Health, the main plaintiff in the case. "I am hopeful that the Supreme Court will uphold the rights that have been in place for four decades and reaffirm that every woman should be able to make her own decision about continuing or ending a pregnancy."
This is a breaking story. We will update this post as the story develops.
Retirees across America look to financial advisers for help in navigating options for smart retirement saving. But there's a scary fact many folks don't know when they entrust their life savings to a broker. According to a report released by Sen. Elizabeth Warren (D-Mass.) last week, many financial advisers promoteinferior financial products to collect kickbacks—from pricey Caribbean vacations to gift cards and golf outings—offered by the companies that sell certain annuities. And what's worse, that practice is totally legal.
The study, called "Villas, Castles, and Vacations: How Perks and Giveaways Create Conflicts of Interest in the Annuity Industry," points out that loopholes in various rules from the Securities and Exchange Commission, the Financial Industry Regulatory Authority, state insurance departments, and other agencies allow this practice to continue. The tainted financial advice costs Americans about $17 billion every year.
To get a sense of the prevalence of these perk-induced conflicts of interest, Warren's Senate office wrote to 15 leading annuity providers, asking whether they offered non-cash incentives, including vacation trips, cruises, and dinners, to annuity sales agents for promoting their financial products. Often, agents have to hit multi-million-dollar sales goals to trigger giveaways, so the letter also asked these companies about their protocols for disclosing sales incentives to annuity purchasers. Warren began the investigation in April, a few weeks after the Department of Labor proposed a rule to help curb conflicts of interest in annuity sales.
None of the companies, says the report, provided complete answers to Warren's questions, but "the responses nonetheless reveal a widespread practice of offering agents kickbacks in exchange for promoting certain annuities…and that such kickbacks are effectively concealed from customers." Thirteen of the 15 companies contacted by Warren's office admitted to offering perks either directly to sales agents or indirectly through third-party providers.Some of the top perks included a 30-day trip around the world for two, a week in Bora Bora, a trip to Monte Carlo, and a week in Rome. Beyond vacations, Warren's office heard from companies that they offered items such as iPads, golf outings, jewelry, dinners at expensive restaurants, and sports tickets.
Here are more examples of the types of perks that companies revealed to Warren's office:
In 2015, American Equity offered the top sellers of its products a trip to San Francisco for agents "and their guests." In 2014, the company offered top-selling agents a trip to Disney World. Children of sales agents who had sold an extra $600,000 worth of American Equity products traveled for free.
For its agents who sell more than $3.5 million worth of Athene products, the company is offering a 2016 trip to a conference in Aruba, with accommodations at the RitzCarlton.
Fidelity Guarantee and Life offered top agents a trip to the company's Power Producer Conference at the Four Seasons Resort in Punta Mita, Mexico.
American National offered its top-performing agents and their guests a five-day, four-night stay at the Cove Atlantis on Paradise Island in the Bahamas.
Existing rules limit non-cash compensation for annuity sales, but these regulations still make it fairly easy to provide kickbacks while staying within the confines of the law, the report found. For instance, companies are allowed to offer expensive vacations when they're tied to sales meetings or conferences. They are also allowed to provide perks via third-party marketing organizations as a way to get around limits on non-cash compensation provided directly to sales agents.
Disclosures of these conflicts of interest to potential buyers are limited at best. Warren's report notes that the company's disclosures are often "buried deep" in the annuity prospectuses—documents describing the financial product—"in complete legalese," and that the descriptions of various giveaways are broad and vague. No company clearly described the nature of the perks provided, or the fact "that these perks may create incentives for the agent to put his or her own interests ahead of those of the customer."
The Labor Department's proposed rule aimed at closing many of the loopholes that created conflicts of interest in annuity sales. If finalized, the rule would explicitly require that all advisers giving retirement advice must act in the best interest of their clients, meaning that they cannot encourage inferior products for their own benefit. The rule would also require financial advisers to clearly disclose conflicts of interest rather than burying them in the fine print.
The public comment period on this rule closed at the end of September. The Republican-led House Financial Services committee has pledged to thwart the measure, and at the end of October, the House passed a bill prohibiting the Department of Labor from finalizing this rule. Historically, this sort of stalling tactic has not gone far: The House passed similar legislation in 2013, but the Senate did not take it up. The three Democratic candidates for president have all backed the rule.
Meanwhile, Warren has kept up her efforts to encourage the rule's passage. In September, Warren wrote letters to the Labor Department and the Brookings Institution, a Washington think tank, questioning potential financial industry input on a report issued by a Brookings scholar that criticized the Labor Department's proposed rule. When the Senate Committee on Health, Education, Labor, and Pensions, on which Warren serves, held a hearing about the rule in July, Warren ripped into the president of investment services provider Primerica, Peter Schneider, over a string of lawsuits alleging that the company gave unsound investment advice to imminent retirees. Schneider insisted that regulators have found that his firm acted properly.
"I'm going to stop you right there," said Warren. "The question about the regulators is the question about is it legal to do that, and that is exactly the problem we've got. It is legal to do that."
At Tuesday night's debate, Ohio Gov. John Kasich ripped into Donald Trump about his plan to deport 11 million immigrants should he become president. "Come on, folks," he said, exasperated. "We all know you can't pick them up and ship them back across the border. It's a silly argument. It's not an adult argument. It makes no sense!"
In response, Trump invoked historical precedent: "Let me just tell you that Dwight Eisenhower. Good president. Great president. People liked him. I liked him. I Like Ike, right? The expression, 'I like Ike.' Moved 1.5 million illegal immigrants out of this country. Moved them just beyond the border, they came back. Moved them again beyond the border, they came back. Didn't like it. Moved 'em waaaay south, they never came back. Dwight Eisenhower. You don't get nicer, you don't get friendlier. They moved 1.5 million people out. We have no choice. We. Have. No. Choice." (You can see video of the entire exchange above.)
The Eisenhower program Trump was referring to, if not by name, was called "Operation Wetback." Implemented by President Eisenhower in the 1950s, the program was frighteningly simple: round up undocumented immigrants and drop them off in Mexico by the busload. The more obscure the location, the better. Dozens of the operation's deportees died. The program was initiated by then-Attorney General Herbert Brownell Jr., who ordered his officers to shoot "wetbacks" trying to enter America. Ultimately, it wasn't even as successful as Trump claims: Some researchers consider the 1.5 million-deported figure to be highly exaggerated.
White supremacists picked up on Trump's reference immediately: