I have been wanting for some time to address a pro-life issue that does not get as much attention as it deserves within the wider pro-life movement: contraception. Closely related to this is a pet concern I have over a state program in Texas that provides government funded contraception to women and which most pro-life organizations and individuals – those who knew about it, anyway – supported. There has not been a time to bring it up since Kassiblog began that tied into an active effort concerning it, so I have waited.
Divine Providence, Feast Days, and The Edith Stein Foundation
The other day I was inspired to finally publish this post when I was reminded of today’s Feast Day, St. Edith Stein, also known as, St. Teresa Benedicta of the Cross, and informed about a fantastic website and organization bearing her name, The Edith Stein Foundation. Its Mission Statement is: “To advocate the dignity of women through fostering a non-contraceptive culture.” Even better is its Vision Statement:
The Edith Stein Foundation seeks to expose the profound and tragic effects that contraception has had on women and therefore society as a whole. We desire to heal the individual and collective wounds through our educational efforts, and inspire a new generation of women to know, love and live the gorgeous dignity that is womanhood in the spirit of Edith Stein, German philosopher, feminist, and canonized Saint. We hope for nothing less than the renewal of culture through woman, family, and society.
Adding to the Providential nature of this inspiration is yesterday’s Feast Day, that of St. Dominic. Why is that relevant? Because Dr. Dominic M. Pedulla is the founder of ESF. You can read more about him and his foundation at the website. I am tremendously grateful for his work and witness. So let’s get down to it. What am I talking about?
The Women’s Health Program Is Born and then Born Again as the Texas Women’s Health Program
There was – and still is – much celebration in the pro-life community in Texas and even nationally over Texas' mostly successful efforts to defund Planned Parenthood ("PP") a while back by excluding it (and its affiliates) from funding through the Women's Health Program ("WHP") and its nearly identical successor program, the Texas Women’s Health Program (“TWHP”).
I have found that very few really know what this entails or what the purpose of it is. This is my effort to clarify and few things, encourage independent thought on the matter, and raise awareness about the nature of this program which is, in its essence, not pro-life even though PP is defunded.
Originally called the Women’s Health Program, WHP was a Medicaid “waiver” program that Governor Perry asked President George W. Bush to allow, which he did. WHP was a program for women under Medicaid who would not otherwise qualify for Medicaid (and its federal funds, hence the need to get a special waiver to use the federal funds for it). In other words, the women were not already pregnant, so they would not get any care under Medicaid. The program provided one annual “family planning exam” which “might” include certain “screenings” but no treatment if anything is found in these very few screenings which “might” be conducted. The primary purpose of this program is “family planning” - that is, contraception and/or sterilization of poor women to save the state money that it would spend via Medicaid if these women were to become pregnant and then have children on Medicaid. It was spelled out on the state website (which is no longer available as it has been replaced by TWHP).
As noted, President Bush allowed Governor Perry this Medicaid Waiver Program several years ago. It has been called very successful because it has prevented Medicaid births. To quote one pro-life organization leader that promoted this effort, “It has been very successful at averting births.” That mindset is very much out in the open.
When the Texas legislature passed Senate Bill 7 in 2011, it precluded funding for Planned Parenthood (or its affiliates) because it made ineligible for funding abortion providers and their affiliates. This meant that PP could no longer get funds for WHP services they were providing but not because these funds go to abortion. (Well, not directly, but they do by way of abortifacient contraceptives and there is the valid argument that money is fungible and so the money could be "mixed" with other PP money which does go to abortions). Rather, PP cannot get money now because it provides abortions in some places and its affiliates are associated with the abortion providing parts of it.
In the spring of 2012, the waiver (remember WHP is a “carve out,” a “special program” that would not otherwise be allowed under Medicaid) had to be renewed by the federal government. President Obama did not want to renew it as long as PP was excluded from the funds. Predictably, a battle ensued. Obama was blaming Perry for playing politics with “women’s health care.” Pro-life activists fought back and said it was Obama who was harming women’s “health care.” (See the section below entitled "Words Mean Things...")
Ultimately, Obama refused to renew WHP and, undaunted, Governor Perry created the Texas Women’s Health Program. While the Governor and those supportive of the program claim that TWHP provides preventative health care and services, a look at the description of “benefits” on the TWHP website shows that it’s not really anything close to preventative health care. It is quite narrowly focused.
The key word here as to what the exam includes is “might.” In our training in the law, we attorneys are taught to pay special attention to seemingly small words that yield great power. Words like “might” or “may” versus “must” or “will” or “shall” change everything. A woman is not guaranteed to have these screenings or anything on that list. They are not required. They are not guaranteed. They are not even the point of the program as has been so clearly explained to me by certain pro-life leaders. And, if you look at the list, the real emphasis is on “family planning” and “birth control.”
If a health problem is found from one of the screenings that “might” be included in your exam, there is no treatment for that here for the woman. That is clear: “This program pays only for the services listed above. If a health problem such as diabetes or cancer is found, you will be referred to a doctor or clinic that can treat you. You might have to pay for those extra services.”
Pro-lifers, and rightly so, have made much of PP’s claim to have mammograms and do breast cancer screenings which are simply a nurse conducting what amounts to a self-exam on a woman. The claims of TWHP as women's healthcare is not really all that different. And, more’s the pity that the language and techniques used here to try to make this program seem to be more than it is to obscure its real purpose mirrors PP so closely. But such is the corruptive nature of government funded programs and the corruptive nature of a contraceptive mentality.
There is a huge problem here for the pro-life movement that goes far deeper than this one program. TWHP is not pro-life in this form even if PP is excluded from funding. If you read the state’s website carefully – which is easy to do because it is very short and to the point – it is clear that if you take contraception out of this program, there is nothing left. There is one annual family planning exam allowed that “might” (the plain language of the site) include screenings. But screenings are not required. And, it is very clear that there is no treatment provided if any screening that “might” occur shows a problem. This is not even remotely health care for women. The pro-life movement has to come to terms with contraception and its direct links to abortion.
Words Mean Things: Don’t Adopt Your Opponent's Bad Language
Recall above that I noted that in response to Obama’s stance on funding PP with WHP money, that pro-lifers responded by saying it was Obama who was harming women’s “health care.” This was a grave error. It was – and is – a mistake to call contraception “healthcare” by members of “our side.” It is dangerous to adopt your opponent’s language in this way, especially when to do so renders some of your other arguments inherently inconsistent.
Recently, pro-lifers have chanted “contraception is not health care” when opposing the HHS Mandate (and the Sandra Flukes of the world) or when we are supporting Hobby Lobby’s freedom of conscience in not funding all types of contraception (it had issues with a few of the contraceptives funded, but still cover 16 others; some of which are hormonal contraceptives and are abortifacients.)
Normally, pro-lifers who understand the issues with contraception talk about how it increases the number of abortions and contributes to the abortion mentality. Normally, pro-lifers understand that contraceptives frequently fail and set up a woman who does not want to be pregnant for an "unplanned pregnancy" which then often sends her straight to an abortionist – be it one at PP or at an independent clinic.
Do we not usually disagree vehemently with the pro-choice side that argues that “if only there was more access to contraception there would be fewer abortions and unwanted pregnancies”? Do we not say that the opposite is true? Around the time that the WHP/TWHP battle ensued, a New York Times column gave statistics from Guttmacher proving the point we usually make in this regard. (And, don't you think that a woman who is open to an abortion but gets her contraceptives at a clinic that does not provide abortions can find her way to one that does later on? Of course she can. While we do not want to fund abortion clinics and abortionists, separating the provider of the contraceptives from the provider of abortions does not change much in terms of what the woman can still go and do. Abortion (as it is usually thought of) was never covered under WHP just as it is not under TWHP.)
Normally, pro-lifers also remember and appreciate the significance of how it was Griswold v. Connecticut (which found a right to privacy for contraception) that was the basis for the reasoning of Roe v. Wade and Doe v. Bolton (in part, extending the right of privacy in Griswold to cover abortion.)
Why were/are pro-lifers supportive of a program based on this same morally and statistically flawed reasoning? Why is this situation any different? Somehow, all of this has been forgotten in the wake of WHP/TWHP perhaps, in part, because pro-lifers are so eager to defund PP that they equate that with being a pro-life victory even when it is anything but. How can we make these arguments and also support TWHP (and also oppose the HHS Mandate)? We cannot. That is why we must be consistent.
And, the most incredible thing about it was that we never had to have WHP and we do not have to have TWHP. Some pro-lifers and at least one organization supported TWHP's creation as "incrementalism" in that PP was to be defunded. But if there is no WHP or TWHP then there is no funding for PP or any other abortion provider by default. It is not like it is the situation where you have a federal program that requires certain things to be funded and states, while they must have the program, can only do so much to alter it. If that were the case, that is, if the situation was such that there had to be a program and all we could do was to defund PP, then that would be an incremental improvement. But that is simply not the case here. With WHP and TWHP, there is no mandate for it other than the governor’s desire. (And, lest one accuse me of bashing the Governor, let me say I am very grateful to him for his leadership on many pro-life efforts. But on this one, like so many other pro-lifers, he is wrong to promote contraception, especially government funded contraception.)
Too Close to Eugenics for Comfort; Money Matters; and a Government “Solution” for Everything
TWHP is not pro-life in this form (just as its predecessor was not pro-life) even if PP and abortion providers and their affiliates are excluded from funding because the very purpose and nature of the program has something awfully close to eugenics as its philosophy. Again, this is no secret.
Remember, the stated (not hidden) purpose of WHP is to “avert births” and save the state money. Whose births are we averting? The poor who are disproportionately minorities. This should sound very familiar if you have read Margaret Sanger or keep up with where PP and other abortion providers build their clinics.
The Texas Medical Association (“TMA”) submitted testimony on a bill concerning WHP that included this nugget:
In the first two years of the program, because of births averted, Texas saved more than $37.6 million in general revenue (GR). This represents a savings of more than $10 for every $1 of general revenue that Texas invested in the program.
Special concern was noted by the TMA that:
Increasing the number of women who enroll in WHP after a Medicaid delivery is especially important. For a new mother, enrolling in WHP is not always a top priority when she’s trying to juggle all the demands of caring for a new baby. Women who have had a Medicaid-funded delivery are at particularly high risk for subsequent pregnancy, often so soon that risks of prematurity and low birth weight are elevated.
Take a postpartum poor woman and encourage (or pressure) her to make a decision to enroll in a program that includes as one of its covered “benefits” sterilization. Nice.
This all sounds very much like former HHS Secretary Kathleen Sebelius' statements in support of the HHS Mandate. It was reported that:
Health and Human Services Secretary Kathleen Sebelius told a House panel Thursday that a reduction in the number of human beings born in the United States will compensate employers and insurers for the cost of complying with the new HHS mandate that will require all health-care plans to cover sterilizations and all FDA-approved contraceptives, including those that cause abortions.
“The reduction in the number of pregnancies compensates for the cost of contraception,” Sebelius said. She went on to say the estimated cost is “down not up.”
Pro-lifers rightly criticized these statements by Sebelius, but at around the same time some of these same pro-lifers were pushing TWHP as incrementalism or as having been "successful at averting births."
While we're at it, let’s just look more closely at some numbers. It is instructive in anticipating what “savings to Medicaid enrollment” TWHP might have by taking a quick look at where Medicaid funding goes and who makes up its enrollment based on a TMA paper.
Yes, this is the same organization that gave testimony linked above about WHP “averting births” (language picked up an used by the pro-life leader supporting TWHP), but here is also admitting that pregnant women do not take up that much Medicaid enrollment. Recall that the Texas Medical Association was and is also very supportive of passive euthanasia in Texas under the guise of the Texas Advanced Directive Act and was supportive of the anti-life legislation I’ve written extensively about known as SB 303.
Based on January 2011 numbers, pregnant women make up only 4% of Medicaid enrollment, 70% of that enrollment is children under the age of 19. However, 70% of Medicaid spending is for nursing home care for the elderly or disabled. What a terrible precedent we set if we engage the Culture of Death to save money for the Medicaid system through (abortifacient and carcinogenic) contraception and sterilization coverage. What is the next step – euthanasia for the elderly or disabled who are taking up most of the resources? (Actually, we’re already sliding down that slippery slope, but we’ve covered aspects of that before here at Kassiblog.) Pro-lifers cannot be any part of this.
Finally, a note about looking to government solutions for everything. It is often (but not always) to be the case that pro-lifers tend to be political conservatives and often fiscal conservatives as well. I am dismayed by the support of a government funded contraception program among those who style themselves fiscal and social conservatives. Now, I am fully aware that people reading this may say, “Fine. Bad program. But we simply cannot afford to have all these kids and pregnant women on the government dole. She’s not offered a solution to save us money.” Three responses to this. First, we are to be moral first and in every circumstance. The ends simply do not justify the means. Second, I recall a time when conservatives preached personal responsibility, chastity before marriage, and so forth and encouraged programs that taught that. Where did they go? Third, step back and let private charities and organizations see to this and, in turn, they should stop looking so much to the government for money (which comes with strings).
How Are Contraceptives Abortifacient? Aren’t “Emergency Contraceptives” Excluded?
Some may ask: How is the Pill or other hormonal contraceptives (which are different from the Morning After Pill or RU-486 which are excluded) abortifacients, i.e., abortion-causing? Hormonal contraceptives – through their thickening of the woman’s uterine lining – prevent fertilized eggs, a newly formed human being, from implanting in the woman’s uterus. That is an abortion.
Many types of hormonal contraceptives work in two ways, by preventing ovulation and/or by preventing implantation. If ovulation occurs while a woman takes a contraceptive that blocks implantation and the egg is fertilized but cannot implant in the uterus – that is an abortion. It may not have been intended, but it can happen. She may not be aware of it, but it is an abortion nonetheless. Many women do not understand this and they deserve the information and to know that there are alternatives to contraception.
This site describes how the uterus is affected and further down you see that these pharmacists explain how the Pill is an abortifacient using long-standing, widely accepted scientific terminology. That is the biology of how hormonal contraceptives work. That is a scientific fact, easily verified. This is neither new nor hidden information. And, these very types of birth control are covered by TWHP.
The so-called “Morning After Pill” and RU-486 are not the only abortifacients. “Plain-old” contraceptive pills and other hormonal contraceptives are also potentially abortifacient. See also the Janet Smith’s writing on the topic; see also this and this link specifically about various methods of contraception being abortifacient.
Some might argue that TWHP offers coverage for NFP (Natural Family Planning) and abstinence training. However, this does not save TWHP because it still covers all of the above, many of which are abortion- (and cancer-) inducing drugs. Furthermore, since when does one go to a doctor or clinic for NFP or abstinence training? Since when do NFP instructors (who are usually volunteers trained through the Couple to Couple League and teach at churches) have Medicaid reimbursement numbers issued by the government? More to the point, how many Catholics (whose religion teaches that NFP is the only moral method to space births) use NFP? There are numbers as low as 4%, which experts believe to be a high number (that is, overly optimistic).
If we extrapolate that number out, knowing that not everyone who is on TWHP is a Catholic, we can be well-assured that the number who might even be inclined toward NFP would be far below 4%. Let’s be generous and assume 2%. Does that make the other 98% of this program morally legitimate? Does it take away the abortifacient, carcinogenic effects of hormonal contraception? Of course not!
Cancer & Other Health Risks
The Pill is classified as Group 1 carcinogen even by the World Health Organization. This is not a new development. It stands to reason that over time, evidence may come to light that indicates other hormonal contraceptives are also carcinogenic.
Cancer is not the only serious complication that can result from contraception. The Pill has a tremendous history of medical complications. There are negative physical as well as psychological effects from contraception.
Can it be healthy for anyone to ingest a chemical that causes this in nature? And, do we really think we’re immune? We’re not.
Please note that “if” a woman receives limited screenings and a cancer or other ailment is found, TWHP does not cover it. Remember that these are women who do not have insurance or they would not quality for TWHP and Medicaid if they become pregnant. So, why are we increasing their risk of cancer and other health complications which they cannot afford? How is that morally acceptable? The ends do not justify the means. Women, including poor women, deserve better.
Those Who Do Not Learn from History Are Doomed to Repeat It
The day after the inspiration to finally publish this hit I was reading Jason Evert's book Saint John Paul the Great: His Five Loves. In describing the Communist takeover of Poland after the Nazis were ousted, and how that was no better for the Poles, he states the following:
G.K. Chesterton once said that the family is a cell of resistance to oppression. Unfortunately, this was one point of Catholic theology that the communists agreed with. To undermine Polish culture, communists struck at its heart - the family. Work and school schedules were organized so that parents had minimal contact with each other and with their children. Birth control and abortion were encouraged, state-sponsored sex education was implemented in schools, and apartments were built to accommodate only small families.
P. 30. (Emphasis added.)
I cannot help but think that it's not really so different philosophically (I'm not at all saying we're living under such a regime, of course, that would be absurd; but we should learn from history) than what we are seeing in America, and, yes, even Texas.
Let’s Be Consistently Pro-Life
When I think about how many pro-lifers and Catholics support contraception and even government-funded contraception, I think we have a lot of work to do within our own ranks and let this be part of my contribution to education. We simply cannot promote government-funded contraception (and all that goes with that which is destructive to women, men, families, society, and even the environment) at the same time we say we’re pro-life.
As I wrote in the context of SB 303 and end-of-life/denial of care issues, is important that we look very carefully into the details of every program, independently and objectively regardless of who else is supporting it. Let us not get caught up in “group think.” It is also vitally important that the pro-life community as a whole, regardless of political and religious affiliation, come to see that contraception and the contraceptive mentality are antithetical to the pro-life movement. Others are beginning to make this call as well.
It is my hope that in time there will be something we can do to try to end TWHP. In the meantime, it is an opportunity for educating ourselves, others in the community, and even activists and leaders in the pro-life movement.
Thanks for reading!