Q&A: The Abortion Battle’s Next Phase

Originally published in The American Prospect on July 12, 2016.
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In a landmark ruling last month, the Supreme Court struck down a package of Texas abortion restrictions known as Targeted Regulation of Abortion Providers (TRAP) laws. Such laws, which have proliferated around the country, typically restrict abortion access by imposing rigid and expensive hospital-style mandates on clinics. The Court’s ruling in the case, known as Whole Woman’s Health v. Hellerstedt, found that the restrictive Texas TRAP laws were unconstitutional because they placed an “undue burden” on women, and marked a major victory for the reproductive rights movement. The American Prospect’s Rachel Cohen spoke with Ilyse Hogue, the president of NARAL Pro-Choice America, which helped lead the challenge to the Texas TRAP laws, to ask about the ruling’s implications for abortion access and for the upcoming election. This is an edited transcript of that conversation.

Rachel Cohen: Now that the Supreme Court has struck down TRAP laws, what’s next on the agenda for anti-choice opponents?

Ilyse Hogue: Over the years, [abortion opponents] have realized that honesty can only get them so far in terms of achieving their goal of ending legal abortion. TRAP laws were really a way to deceive the public, cloaking their efforts around the idea of protecting women’s health. The Supreme Court just eviscerated the anti-choice posturing that TRAP laws are in any way about women’s health.

So one of their favorite tools just got taken away from them. They are reeling, but they are not the type to take their ball and go home. We’re anticipating them pushing forward on a number of different fronts. I think they will step up their harassment at clinics—harassing patients and doctors. And we’ve seen some really insidious things from state legislatures, like recently an effort in Missouri to force clinics to turn over their private medical records to the state. I think we’re going to see anti-choice opponents continue to pour resources into crisis pregnancy centers, which are just another way to deceive women.

How will the reproductive rights movement respond?

We are pushing back on their crisis pregnancy center efforts. In California last year, legislators passed the Reproductive FACT Act, which sets a national model for requiring all crisis pregnancy centers to be really clear with their patients about what they do and don’t do. Other states are looking at California’s law, and I think it’s very much at the top of legislators’ minds for the beginning of 2017.

We’ve also seen states where pro-choice legislators are filing to appeal TRAP laws that are already on the books, like Daylin Leach, a Democratic state senator, in Pennsylvania. And we’re working as a movement to step up litigation and public education to repeal the rest of those laws around the country. Importantly, we’re really moving to a position where we will not just fight anti-choice lies and deception, but where we can actively push for legislation that expands access to abortion. For example, a number of states are looking at medical abortion, and allowing nurse practitioners to provide abortion services. California already has that and other states are looking at it.

On top of this, we’ve got two pieces of federal legislation that are picking up momentum. The Women’s Health Protection Act, which would enforce and protect the right of a woman to decide for herself whether to continue or end a pregnancy, and the Equal Access to Abortion Coverage in Health Insurance Woman Act, which would repeal the Hyde Amendment and ensure that abortion services could be covered under federal health insurance.

NARAL recently released a statement calling the Democratic Party platform “the strongest platform for reproductive freedom we have ever seen.” What’s so significant about it?

The platform is a symbolic statement of values, as well as a navigation tool for what kinds of legislative and public policy remedies there are for the issues that we face. So the fact that it explicitly calls for the repeal of the Hyde Amendment, as well as the Helms Amendment, [which restricts U.S. foreign aid from paying for abortion services] is huge. It acknowledges that there have been discriminatory practices both here and abroad against women who want to control our own reproductive destiny.

The reproductive justice movement deserves an enormous amount of credit for getting us here. Reproductive freedom in the 21st century is acknowledging that we are whole beings. There is not one group of women who gets abortions, and others who go on to be parents. We are just the same women at different times in our lives, making the decisions that are best for us and our families. That the platform takes a step towards acknowledging that is a real testament to the economic and reproductive movements that have come together.

How long will it take Texas and the other states with TRAP-style restrictions to restore abortion access to women?

I’m really glad you asked that question. The answer is too long and it varies state by state. Texas is five times the size of other states, so it will take longer there. But what’s important in answering that question is acknowledging that in the minds of the extreme anti-choice minority, this was a scorched-earth strategy. They always knew they could lose at the Supreme Court, but the amount of damage they were able to do in the meantime, in terms of clinics on the ground, in terms of women who could not access services—that’s significant damage that can never be fully undone.

While it’s important to win, we can’t actually let them gain such ground in the future. We can’t just depend on Supreme Court strategies when it comes to ensuring women access to our basic rights.

That brings us to the election. What role do you expect abortion and reproductive health to play in state and federal races?

We have to be very focused, not only on getting our champion into the White House, but on the down-ballot races, because the harm is coming disproportionately from state legislatures.

We’ve been doing a lot to hold incumbents accountable for the unbelievable amount of times they’ve tried to restrict access to abortion. Their constituents did not elect them to do that, especially at the expense of all the important business that has not gotten done. In both the federal election and for local and state races, we’re making sure voters have the information to hold their officials accountable.

This is a long-term project. We’ve got to make gains in 2016, and come 2020 and 2022, I think we’re going to start seeing some of these state legislatures really shifting on these issues.

In the 2012 election, Todd Akin, a Republican candidate from Missouri lost his race, in large part because of his outrageous comments about “legitimate rape.” Are we seeing similar types of remarks from Republicans this year?

I think people have been trained to be more careful, because when they speak their truth they find themselves at odds with the majority of their constituents. These anti-choice candidates don’t want to talk about their position once they get to a general election because they know they’re on the wrong side, and they don’t win elections if they do. We saw that so clearly in 2014 when Scott Walker, three weeks before his Wisconsin election, ran an ad saying he supports legislation to provide women with more information and to leave the final decision to a woman and her doctor. This is coming from a man who had done more to legislate abortion out of existence than every previous governor before him.

But I think what’s changed between 2012 and 2016 is that back then, the pro-choice movement was able to leverage those off-the-cuff Republican statements. But we’re not going to wait for them now. We’re going straight to the voters to remind them about their officials’ records. We did that really recently in New Hampshire with an  ad campaign targeting Republican Senator Kelly Ayotte, reminding her constituents about all the anti-choice work she spent her time working on, when they didn’t want her to.

What about Donald Trump? He went so far as to say that women should be punished for getting abortions, but then quickly walked it back.

Donald Trump is not playing by the anti-choice or the GOP rulebook in any way, and we know that. One thing that’s super important to me from where I sit at NARAL, but also as an American, and as a mom, is just the way he’s giving voice and credibility to deeply-held misogynistic ideas. I think he will do tremendous damage whether he wins or not, because he has given permission to this very dark underbelly that does not represent what we need to be or what we can be. This is especially true when it comes to his misogyny, and his willingness to dehumanize women. I think particularly because he is facing a woman opponent we’re going to see a new wave of misogynistic activists who feel like they have the high ground.

How has Obama been on reproductive rights? NARAL endorsed Hillary Clinton in January. Might Hillary be different from him?

Obama has been a great backstop against the endless assault by the anti-choice majority in Congress. He has vetoed every bill we’ve needed him to veto in no uncertain terms. But what we need now is a leader in the White House who centralizes these ideas about reproductive freedom as human rights, integral to the health and security of women and families in America. That’s not really been the center of his presidency, and I think it will be the center of Hillary Clinton’s.

California’s New Crisis Pregnancy Center Law Creates a Roadblock for Anti-Abortion Activists

Originally published in In These Times on October 30, 2015.
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Earlier this month, California Governor Jerry Brown signed the nation’s first statewide law to regulate crisis pregnancy centers (CPCs). CPCs are facilities that work to counsel women out of having abortions, offering them resources like diapers, baby formula and maternity clothes, but also often disseminating misleading or outright false medical information. Boosted by government funding under George W. Bush, they have proliferated over the past 15 years, with an estimated 3,500 nationwide—outnumbering real abortion clinics 3-to-1.

California’s Reproductive Freedom, Accountability, Comprehensive Care and Transparency (FACT) Act, which overwhelmingly passed the state assembly in May, is being hailed as a landmark victory in a nationwide effort to push back against the rise of CPCs.

The new law, set to take effect January 1, will govern California’s nearly 170 CPCs, about 60 percent of which operate with no medical license. The law requires unlicensed facilities to post a notice—in “no less than 48-point type”—stating that they have neither a state medical license nor licensed medical staff. Licensed CPCs, for their part, will be required to inform women about available public assistance for contraception, abortion and prenatal care.

Whether or not the law can withstand a court challenge, however, remains to be seen. The decades-old movement to regulate CPCs has been repeatedly thwarted by First Amendment challenges.

Although CPCs began cropping up in the late 1960s as individual states lifted their bans on abortion, the clinics flew under the radar until the 1980s and 1990s, when they became a subject of a heated debate that went all the way to halls of Congress. Detractors argued that CPCs’ strategies to lure in women—such as offering free non-diagnostic ultrasounds and staffing their non-medical volunteers in white lab coats—amounted to false advertising. Defenders said their actions were protected speech.

The passage of the Personal Responsibility and Work Opportunity Reconciliation Act in 1996—or “welfare reform”—increased federal funding for abstinence education and helped to fuel the expansion of CPCs, as In These Times reported in 2002. The law enabled the Bush administration to funnel $60 million in federal abstinence-only funds to crisis pregnancy centers between 2001 and 2005, often doubling or tripling the centers’ annual budgets.

In response, a number of investigations into CPC practices were launched. A 2006 congressional investigation, initiated by Rep. Henry Waxman (D-Calif.), looked specifically at CPCs that received federal funding, and found that most provided women with false or misleading medical information, which “often grossly exaggerate[ed] the risks.” (Federal funding for CPCs continues today, despite the Obama administration’s efforts to end it.) NARAL, a national pro-choice organization, has also been investigating CPCs for more than a decade, and has discovered that staffers routinely overstated the risks of abortion or simply lied—telling women that ending a pregnancy would lead to infertility, breast cancer or even suicide. A 2008 NARAL investigation into 11 crisis pregnancy centers across the state of Maryland found that “every CPC visited provided misleading or, in some cases completely false, information.”

Drawing on the Waxman report and NARAL’s investigations, in 2009, Baltimore passed the first-ever legislation designed to curb CPCs’ misleading advertising practices. Challenging CPCs from a false advertising perspective was, in part, a strategic decision. As Slate’s Emily Bazelon reported in 2009, “There’s a whole branch of law, commercial speech, to explain why false advertising gets less First Amendment protection.” The law required Baltimore CPCs to display signs—in both English and in Spanish—clarifying that they do not provide abortion or birth control referrals. Similar laws were soon passed in New York City, Austin, and San Francisco.

These ordinances were all challenged in court on First Amendment grounds. CPC backers argue that the regulations violate their religious freedom and their right to free speech. Baltimore’s law was struck down in 2011 and is still tied up in court appeals. Austin’s was overturned, as were key aspects of New York’s law. Given their free services and nonprofit statuses, judges have tended to see CPCs’ speech as “noncommercial”—a designation that generally receives greater constitutional protection than commercial speech. But San Francisco’s law, which passed in 2011, has thus far withstood legal challenge.

Pro-choice advocates in California treaded very carefully in drafting the FACT Act. “We paid a lot of attention to the bills crafted in other cities,” says Amy Everitt, the state director of NARAL Pro-Choice California. NARAL also enlisted the help of Attorney General Kamala Harris, a Democrat, to identify language that might be deemed unconstitutional.

Everitt explains that laws which require centers to post signs describing what they do not provide (such as abortion referrals) have tended to be more legally vulnerable than those that require facilities to distribute “neutral” information about available government services. So the FACT Act only requires licensed clinics to inform women of the many services available to pregnant women. In California, state Medicaid funds can cover the cost of an abortion, and millions of Californian women became eligible for Medicaid with the passage of the Affordable Care Act.

“In California, we have some of the best pro-choice policies in the whole country, but if women aren’t aware of what’s available to them, then they can’t use them,” says Everitt. “They need to find out about their options, and they need to find them out when they are actually out seeking care and information.”

Crisis pregnancy centers have already filed two suits against the Reproductive FACT Act. The law “is an outrageous and unconstitutional violation of both the right of free speech and the right of freedom of religion for our members in California,” said Thomas Glessner, the president of the National Institute of Family and Life Advocates, in an email quoted in Life News.“The Act unconstitutionally forces pro-life pregnancy centers, on pain of government penalty, to engage in government disclaimers that they would not otherwise provide.”

In response, Everitt notes that the state has a “public health interest” in ensuring that women can access high-quality reproductive care. “Women are seeking their options,” she says. “They are going online and they are looking for information to make their decisions about unintended pregnancy or pregnancy scares, and they were not getting the information they wanted in certain places like CPCs.”

Crisis pregnancy center advocates usually deny that CPCs mislead women, arguing that those who come to visit are well aware of the clinics’ anti-abortion slant. But investigations by reproductive-rights groups and Congress have found that CPCs often set up shop in close proximity to real reproductive health facilities and hide their anti-abortion agenda when women call seeking information. CPCs have also spent significant sums of money to advertise their services misleadingly in newspapers, on billboards, on social media and through Internet search engines.

While the fate of California’s new law remains uncertain, energized advocates are determined to build on their newfound political momentum. Everitt says she hopes their new law will serve as a model “for every state to pursue.”The new measures are “what it looks like to respect women,” adds Ilyse Hogue, the president of NARAL Pro-Choice America.“Empower us and trust us to make the best decisions for ourselves and our families.”

We know College Feminists Care About Sexual Assault. What About Abortion?

Originally published in The American Prospect on October 24, 2014.
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In the past three years, more abortion restrictions have been enacted in the United States than in the entire previous decade. At the same time,85 colleges and universities are now under federal investigation for their handling of sexual violence. While these two issues are not divergent, campus feminists have devoted much of their energy to challenging their universities’ failure to adequately handle sexual assault cases—often at the expense of abortion rights advocacy.

But the growing threats to reproductive justice—like the Texas law that could shut down most of the state’s abortion clinics, and looming ballot measures in Colorado, Tennessee, and North Dakota that could result in women losing their legal right to terminate a pregnancy—have catalyzed the ongoing efforts of national pro-choice organizations to invest in student leaders. Campus activist priorities and national women’s rights goals might finally be aligning—sort of.

For many students attending schools in East and West Coast states, the legislative efforts to restrict abortion access commonly found in red states can seem quite distant from their own daily gender struggles. Changing local culture around rape and sexual assault, on the other hand, seems far more urgent.

“Campus activism tends to be reactionary, and women are generally kept on the defense,” says Sarah Beth Alcabes, a recent graduate of the University of California, Berkeley. “It’s hard to organize for coherent proactive action beyond the immediate threats we face. Maybe if campuses were safe for women, there would be energy for them to focus on places not in their immediate vicinity. But that’s not the case.”

At Johns Hopkins University in Baltimore, students have filed an anoymous Title IX complaint alleging that the school failed its responsibility to ensure the safety of students when it allowed a fraternity to continue throwing parties even after police began an investigation into an alleged gang rape that took place at the frat house. One of the complainants says that the focus of leaders on her campus has been the enforcement of federal sexual assault laws for a simple reason: “There’s no equivalent to those sorts of laws for abortion,” she explains, “so the pro-choice movement doesn’t occupy the same place as gender-based violence on the college campus.”

But geographic distance from the most pressing abortion battles and political momentum around sexual assault prevention are only part of the story. Even in those states where access is regularly threatened, many college feminists have avoided tackling the issue of abortion directly—in part because the abortion debate is so polarizing, and in part because many campuses are unwilling to institutionally support such activism.

At Texas Tech University in Lubbock, Sophia Dominguez, the president of the Texas Tech Feminist Majority Leadership Alliance (FMLA), says she believes that reproductive rights are an important feminist issue, but her group must “recognize the political culture of Texas and adapt [its] advocacy accordingly.” She says her peers feel “repressed in the ways in which to openly discuss and address reproductive freedom.” As such, Tech FMLA has been fighting Texas Tech’s rape culture, which students believe is a more immediate problem to tackle, even in light of the Texas legislature’s anti-abortion efforts.

Kierra Johnson, executive director of URGE, a national campus organization committed to reproductive and gender equity, says that the leaders of many URGE chapters tend to focus on sexual assault because there is less official support for abortion work, even when a group is affiliated with a campus women’s center. “We might be able to push for more access to contraception,” Johnson says. “But the more the conversation centers around abortion, the more uncomfortable the administration is with getting behind it. Regardless of how people feel about abortion, when you talk about it, it charges an environment, and that’s the last thing campus administrators want.”

Several national organizations—the Feminist Majority Foundation, Planned Parenthood for America, NARAL Pro-Choice America, and URGE—are trying to change these campus dynamics by building networks of college students who will advocate for reproductive justice and gender equality. While coordinated inter-campus solidarity is currently pretty minimal, efforts to build a larger college pro-choice infrastructure are growing.

But even with support from outside organizations, building a student pro-choice movement is tough. Molly Waters, a senior at Webster University in Webster Groves, Missouri, works as one of NARAL’s campus representatives for the Choice Out Loud campaign, an effort to help millennials engage in conversations about reproductive rights.

“I don’t think abortion is the first thing feminist students would organize around, just because it’s so polarizing and has such a stigma,” Waters says. “I understand it. I myself am a Christian. I think a lot of people are more tempted to discuss birth control or general reproductive rights and not so much abortion rights.”

NARAL donates supplies to campus chapters, organizes conference calls between campus representatives in different states, and facilitates national communication through Facebook groups. Yet Waters observes that many students just seem to have a general lack of interest in political activity. “One thing that can be really frustrating is just how many people don’t want to protest or be active as much,” Waters says. “And that’s understandable; we’re in college, we have a lot on our plates. But there does seem to be a lack of energy for action.”

Kaori Sueyoshi, a senior at the University of North Carolina at Chapel Hill, feels more optimistic. “The student movement here in North Carolina has been growing quickly with the Republican takeover of our state,” she explains.

In 2010, Republicans won the majority in the state legislature, and won the governor’s mansion in 2012. Since then, North Carolina has enacted a controversial set of abortion restrictions, as well as a stringent voter ID law. In turn, over the past two years, college students across North Carolina have gathered together to network, strategize, and advocate for reproductive rights in their communities. Sueyoshi has been involved with Planned Parenthood’s network of campus activists, known as Generation Action, and attended the Youth Organizing & Policy Institute, a national student conference that Planned Parenthood hosts in Washington, D.C. “I think the national college advocacy movement is growing much stronger,” she says.

She may be right. At Vanderbilt University in Nashville, Tennessee, Marlies Biesinger, co-president of the Vanderbilt Feminists, says that advocacy around abortion politics has never been a real priority for them. But for the first time, in light of the political buzz around Tennessee’s Amendment 1—which could give the state legislature, not the state Supreme Court, full authority to decide the legality of abortion—the Vanderbilt Feminists have started to hold educational events to raise awareness about the ballot measure’s implications and push students to vote this November. And at Rice University in Houston, Rice for Reproductive Justice formed just last year to campaign for gubernatorial candidate Wendy Davis and organize around a broad set of issues that inhibit reproductive freedom.

If threats to safe and legal abortion access continue to drive both college advocacy and the formation of relationships between student leaders, the questions then become: What can these activists actually do together? How, when anti-choice measures are primarily passed through state legislatures, can national advocacy play an effective role?

“The movement has shifted,” Johnson says, because anti-choice activity has moved from the federal to the state level. “For a long time there were lots of opportunities to engage on a national level. But we’re not going to mobilize people in Alabama to work on Texas. No matter how much noise you make, at the end of the day the elected officials only care how people are voting in their state and districts.” While broad-based online petitions exist, like those organized by Change.Org and Moveon.org, right now there just are not a lot of opportunities for pro-choice activists, in or out of college, to campaign on the federal level.

Despite the relatively limited array of federal policy opportunities, the need to mobilize and educate students about reproductive rights remains pressing. The All* Above All campaign, which is focused on lifting health insurance bans on abortions, is one possible avenue for students to pursue. “There’s just a real lack of awareness about what these abortion restrictions are, so we need to educate constituents and our elected officials,” Johnson says.

For Waters, the more progressive culture of her Missouri liberal arts college feels worlds away from the conservative southern Illinois town she grew up in, where mentioning abortion rights would “automatically make you a Satanist.” Coming to college and finding a new environment to educate herself, and later educate and agitate others, has been transformative. “You know, it’s taken a while for me to get there,” Waters says. “It takes a lot of education that many people just don’t usually have.”