Issue Position: Hillary Clinton's Agenda for Women's Reproductive Health Care
On the 35th anniversary of Roe v. Wade, Hillary is recommitting to Roe as the law of the land and charting a new course for women's reproductive health care based on preventing unintended pregnancy. Hillary envisions a world in which every child born is wanted, cherished, and loved. She believes in empowering people with honest and complete information so that they can make responsible decisions, and in providing broader access to contraception, family planning, and the full range of reproductive health care services for women of all income levels.
Hillary has been a leading advocate for the right of every woman to make the most personal of life decisions for years. She believes the right to privacy is a fundamental right, and that abortion should be safe, legal, and rare. Her views on reproductive rights were informed by seeing what happens when the government gets involved in these decisions. As First Lady, Hillary traveled to Romania where, under a Soviet-style dictatorship, the government had controlled every aspect of women's reproductive health by eliminating birth control, sex education and abortion and requiring humiliating government-controlled monthly exams, in order to compel every woman to bear five children and build the Romanian state. Hillary saw the other extreme in China, with its one birth policy, under which women could be sterilized or forced to have an abortion if they got pregnant for a second time. Hillary took those lessons to heart.
In the Senate, she has been an outspoken critic of the Bush Administration's relentless and insidious attempts to undermine Roe and has been on the forefront of the major victories on behalf of the pro-choice community in recent years. In the Senate, Hillary waged a three-year effort, along with Senator Patty Murray, to get the FDA to accept the overwhelming recommendation of the medical community and approve emergency contraception for over-the-counter sales. She also helped craft a winning strategy to put the right wing on the defensive by highlighting their opposition to contraception, a position that is way out of the mainstream in the U.S. Hillary championed the Prevention First Act, which expands access to contraception for women of all income levels, and provides for honest and complete sex education programs. As President, Hillary will be vigilant in ensuring that each woman maintains the right to plan her own family and protect her reproductive health.
Maintaining Roe as the Law of the Land
Appointing Justices that will uphold the right to privacy - Senator Clinton opposed the nominations of Justices Alito and Roberts to the Supreme Court because she believed they represented the greatest threat to Roe since it was decided. Her prediction has been born out through Gonzales v. Carhart, the first time the Supreme Court upheld a law outlawing a specific abortion procedure. As President, Hillary will nominate justices who share her view that the Constitution protects a woman's right to make the most fundamental decisions about her life and health, and that the right to privacy is a fundamental right.
Enacting the Freedom of Choice Act - Hillary will sign into law the Freedom of Choice Act, which would codify Roe v. Wade and send a renewed signal to the courts that the will of Congress and the President is to keep abortion legal.
Preventing Unintended Pregnancies
Hillary has long believed that abortion should be safe, legal, and rare. Unfortunately, we are far from realizing that vision. One half of pregnancies in the U.S. are unintended and one half of unintended pregnancies end in abortion, and the U.S. has one of the highest rates of teen pregnancy in the industrialized world. Hillary's agenda will help reduce the number of unintended pregnancies by:
* Increasing access to family planning services. Hillary will expand the national family planning program (Title X) and extend Medicaid coverage for family planning services to women who are eligible for pregnancy-related care. Each year, Title X provides 4.8 million people, mostly poor and uninsured, with family planning services that help them plan their pregnancies and improve their health. Clinics that use Title X funds are present in close to three-quarters of counties in the U.S. Over the last two decades, Title X services are estimated to have prevented 20 million unintended pregnancies and nine million abortions, and helped to prevent 5.5 million adolescent pregnancies [Planned Parenthood]. President Bush has proposed no increases in Title X since taking office. As a result, health care providers that rely on Title X funds have significantly lost purchasing power and are struggling to afford the latest technology in diagnostic and contraceptive services. According to the Guttmacher Institute, the $286 million allotted to Title X for FY 2005 was worth 59 percent less than the $162 million appropriated in FY 1980. Hillary will restore the funding for Title X that has been lost under the Bush Administration. She will also ensure that states make family planning services as widely available as pregnancy-related services in Medicaid.
* Ensuring that private health plans offer the same level of coverage for contraception as they do for other prescription drugs and services. Massive shifts have occurred in the number of women with access to contraception through their health insurance over the past 15 years. In 1993, according to testimony by the Executive Director of the Women's Research and Education Institute, women typically spent 68% more in out-of-pocket health care costs than men, a difference that was largely accounted for through reproductive health services. Today, nearly nine in ten employer-provided health insurance plans cover the full range of prescription contraceptives [AGI, 2004]. Still only half of all women of live in states that require contraceptive coverage of employers, and millions of women who don't receive health insurance through their employers aren't reached by these state laws [AGI, 2004]. As president, Hillary would work to enact the Equity in Prescription Insurance and Contraceptive Coverage Act, which would require health insurance plans to cover contraception to the same degree that they cover other forms of prescription drugs.
* Ensuring that women who survive sexual assault have access to emergency contraception (EC) upon request. Emergency contraception is a safe and effective way to help women who may be at risk for an unintended pregnancy. Yet, according to seven years of data from the Centers for Disease Control, fewer than half of all women who visited an emergency room after a sexual assault received emergency contraception becoming pregnant [Annals of Emergency Medicine, 2002]. Fourteen states already require hospital emergency rooms to provide emergency contraception-related services to sexual assault victims. Hillary would enact legislation to require hospitals to inform women who are victims of rape and sexual assault that EC is an option for them, and make it available or provide a referral upon their request, or risk losing federal funding.
* Implementing important public education initiatives about EC. Emergency contraception is a safe, effective back-up birth control method that reduces the risk of pregnancy by 75% [Boonstra, AGI, 2002]. Despite the widely acknowledged safety, efficacy, and acceptability of EC, many women do not know EC is an option for them and only 6% of women have ever used it [Kaiser Family Foundation, 2005]. Hillary would support efforts to increase awareness so that women can have full information about this proven option.
* Restoring the discount for birth control on college campuses and community health centers. The Deficit Reduction Act of 2005 eliminated the ability of college health clinics and about 400 community health centers to receive deep discounts on contraception and pass those savings onto students. As a result, college students and low-income women across the country have seen the price of contraception rise by 300 or 400%. Many are choosing to take a risk on unprotected sex rather than pay the increase. Others are cutting down their budget for food or other necessities. Hillary will make restoring this discount a top priority.
* Supporting sex education programs that provide honest, accurate, complete information about abstinence, contraception, and disease prevention. Senator Clinton supports a more comprehensive approach to sex education that teaches young people to delay sexual activity, but also teaches them the basics of human sex and how to protect themselves from unintended pregnancy, HIV/AIDs and other sexually transmitted diseases. Fourteen states have rejected President Bush's strict abstinence-only approach [Washington Post, December 16, 2007]. Hillary would provide funding for medically accurate, age appropriate, comprehensive sex education programs.
* Funding teen pregnancy prevention programs. The U.S. has one of the highest rates of teen pregnancy in the industrialized world, and teen pregnancy is associated with a host of poor outcomes for the parents and children of teen parents - lower employment rates, higher rates of welfare dependence, higher school dropout rates, and poorer health and academic outcomes. Hillary would set a national goal of reducing teen pregnancy by one third and invest in initiatives with a proven record of reducing teen pregnancy. In December, the CDC National Center for Health Statistics announced that the teen birth rate rose for the first time since 1991. Over the fourteen years preceding, the teen birth rate fell by 34 percent. Hillary will bring a concerted focus to breaking the cycle of teen pregnancy, and in doing so tackle the root cause of many social problems and help to improve prospects for young people, strengthen families and our nation.
* Conducting research into preventing unintended pregnancy. Hillary will invest in research efforts identify the most promising strategies for reducing the rate of unintended pregnancy. She will fund a pilot program to do rigorous analysis of the programs and strategies currently being undertaken, and will use the results of the research to determine the most effective strategies and practices going forward. Hillary will ensure that investments we make in reducing the number of unintended pregnancies are evidence-based, not ideologically driven.
Providing Greater Access to Reproductive Health Care Services Overseas
* Overturning the Global Gag Rule and Reinstating the United Nations Population Fund. Hillary has said that on day one of her Administration she will overturn the global gag rule, which prohibits Non-Governmental Organizations (NGOs) from even talking about abortion in the event of an unplanned pregnancy. This rule has had devastating consequences on access to reproductive health care for women by forcing NGOs, which are sometimes the only health care provider for women's health in a poor community, to choose between foregoing the funding they need to be sustainable and providing honest and accurate information to women about their options. In countries like Nepal, which are grappling with high rates of maternal death as a result of unsafe abortion and growing rates of HIV/AIDS, the global gag rule has devastated the limited reproductive health care infrastructure. Hillary will also reinstate for the United Nations Population Fund, which provides vital funding for family planning abroad. President Bush has eliminated this funding every year of his administration.
* Reproductive Health Services for Women Stationed at Military Bases Overseas. Nearly 3,000 military women reported being victims of sexual assault last year. Yet, women living on military bases overseas often have a hard time accessing emergency contraception and are prohibited from using their own money to pay for an abortion at a military medical health care provider. Hillary introduced the Compassionate Care for Servicewomen Act, which requires full access to emergency contraception for servicewomen at all U.S. military health care facilities around the world. As President, she will enact this legislation. President Clinton issued an executive order in 1993 to lift the ban on paying for abortion with private funds, but it was overturned by Congress in 1995, and has been in place every since. Hillary believes women stationed on U.S. military bases overseas should have the same access to the full range of reproductive health care as women living in the U.S., and as president she will work towards that day.