Laws Affecting Reproductive Health and Rights 2015 State Policy Review

By Elizabeth Nash, Rachel Benson Gold, Gwendolyn Rathbun and Zohra Ansari-Thomas

During the 2015 state legislative session, lawmakers considered 514 provisions related to ballgame; the vast majority of these measures—396 in 46 states—sought to restrict access to abortion services. This year volition be remembered non only because 17 states enacted a total of 57 new abortion restrictions, but too because the politics of abortion ensnared family planning programs and providers also equally critical, life-saving fetal tissue enquiry.

2015 may also be memorable for setting the stage for what is widely anticipated to be one of the most significant Supreme Court rulings on ballgame since 1992. In Nov, the Court agreed to hear a challenge to a Texas law requiring abortion providers to adhere to the standards prepare for convalescent surgical centers and to take admitting privileges at a local hospital. At pale is the question of how far states may go in regulating abortion before their actions amount to an unconstitutional "undue burden" on women's power to admission care. The Courtroom volition hear the example in March 2016, with a determination expected in June; it is still considering whether to review a Mississippi albeit-privileges law. (As well in 2016, the Court will revisit the contraceptive coverage guarantee under the Affordable Intendance Act, weighing its importance and approach against the contention of religiously affiliated employers that they deserve to be entirely exempt from the law.)

At the same time, states made important advances in 2015 on other sexual and reproductive health and rights issues:

• Oregon adopted a measure allowing adults to obtain prescription contraceptives from a pharmacy without first obtaining a prescription.
• The District of Columbia and Oregon adopted measures requiring health plans to allow a woman to obtain a full year's worth of prescription contraceptives at 1 time.
• Oregon adopted a measure protecting confidential communications around sensitive health services for individuals covered as dependents nether private insurance.
• Maine directed the country to move to expand Medicaid eligibility for family unit planning services to individuals with an income of upwards to 209% of the federal poverty level.
• The District of Columbia adopted a provision prohibiting employers from discriminating against employees because of their use, or intended use, of contraceptives, ballgame services or fertility treatments.
• Idaho and Maryland adopted measures assuasive health care practitioners to provide STI treatment for a patient'south partner without first examining the partner.
• California adopted a measure requiring crisis pregnancy centers and wellness centers that provide family planning to mail information near the availability of complimentary or depression-cost pregnancy-related care, including abortion services.
• 4 states—Alabama, Arkansas, Maine and Oregon—moved to require that sex educational activity provided in the state include information on violence prevention.
• Illinois and Oregon adopted measures prohibiting "conversion therapy" designed to change sexual orientation as role of mental health treatment for minors.

Access to Ballgame Services

Including the 57 abortion restrictions enacted in 2015, states have adopted 288 abortion restrictions just since the 2010 midterm elections swept abortion opponents into ability in state capitals across the state. To put that number in context, states adopted nearly equally many ballgame restrictions during the final five years (288 enacted 2011–2015) as during the unabridged previous 15 years (292 enacted 1995–2010). Moreover, the sheer number of new restrictions enacted in 2015 makes it clear that this sustained attack on abortion access shows no signs of abating.

The 288 new restrictions enacted since 2010 include a broad range of approaches, from banning some abortions to putting restrictions on the providers allowed to perform the procedures to limiting insurance coverage.

Thirty-ane states—spanning all regions of the country—enacted at least one abortion restriction during the last five years. The 10 states that enacted at least ten new restrictions together account for 173, or 60% of the 288 new abortion restrictions adopted over the last 5 years. These states are overwhelmingly located in the South and the Midwest, and it is likely that access to services for women in these regions has been impacted significantly. Iv states—Arkansas, Indiana, Kansas and Oklahoma—each enacted at to the lowest degree 20 new abortion restrictions, making this scattering of states, which together adopted 94 new restrictions, responsible for a third of all ballgame restrictions enacted nationwide over the last five years. Kansas has the dubious distinction of leading the pack with xxx new ballgame restrictions since 2010.

Although the 57 new abortion restrictions enacted during 2015 include a broad range of provisions, four topics stood out as the field of study of particular attention among lawmakers.

• Counseling and Waiting Periods

Five states adopted waiting menses legislation in 2015. Florida enacted a 24-hr waiting period, while Tennessee approved a measure out mandating a 48-60 minutes wait. Iii boosted states lengthened existing waiting periods: Arkansas extended the mandatory await to 48 hours; Due north Carolina and Oklahoma lengthened the fourth dimension to 72 hours. (The new Florida constabulary has been temporarily blocked past the courts; the Oklahoma constabulary is too existence challenged, simply a state court allowed it to go into effect while the case is pending.) Including these new laws, 27 states have waiting periods in effect (see Counseling and Waiting Periods for Abortion).

The new laws in Florida and Tennessee crave the woman to receive state-mandated ballgame counseling in person, meaning that she must make two separate trips to obtain an abortion. With enforcement of the Florida law blocked, 13 states take 2-trip requirements in issue.

• Medication Abortion

Four states sought to utilize longstanding strategies to restrict admission to medication ballgame. Arkansas, Idaho and Kansas enacted new measures banning the employ of telemedicine for the provision of medication abortion. (A like mensurate was vetoed in Montana by Democratic Gov. Steve Bullock.) Arkansas also mandated use of the regimen specified in the FDA-approved labeling, which bans apply of the newer testify-based regimen that is less costly, has fewer side effects and tin can be used several days later in pregnancy; the law is not in issue due to a courtroom case. Currently, 18 states ban use of telemedicine and three mandate apply of the older medication abortion regimen (come across Medication Ballgame).

Arizona and Arkansasdebuted a new approach to discouraging a woman from obtaining a medication abortion. Both states adopted laws requiring doctors to counsel women that the abortion could be stopped if the woman takes a loftier dose of progesterone afterwards receiving the start of the 2 drugs included in the medication abortion regimen. According to the American Congress of Obstetricians and Gynecologists, this new approach is based on scant scientific evidence; it relies on a single flawed study of only 6 cases that did non have oversight by an institutional review board. The Arizona law is blocked pending a legal claiming; the Arkansas law is in consequence.

• Abortion After the Offset Trimester

Ballgame opponents unveiled a new strategy in 2015 by moving to ban the use of the procedure used most often for second-trimester abortions. Kansas and Oklahoma both enacted measures to ban this prophylactic and medically proven method that has long been used for abortions afterwards 14 weeks; both laws are enjoined pending court action.

Due west Virginia and Wisconsin enacted laws banning abortion at or later on 20 weeks postfertilization (which is equivalent to 22 weeks after the woman's last menstrual period). The West Virginia measure is in effect; the ane in Wisconsin is slated to get into effect in Feb. Currently, 12 states (AL, AR, IN, KS, LA, MS, NE, NC, ND, OK, TX, WV) accept similar bans in event (see Land Policies on Later on Abortions).

• Targeted Regulation of Abortion Providers (TRAP)

Even as the phase was being set for the U.S. Supreme Court to review TRAP laws (see above), legislative action connected rapidly in several states. Five states adopted TRAP laws in 2015. Post-obit a 2014 ballot initiative that granted lawmakers the ability to enact virtually limitless abortion restrictions, Tennessee enacted a new TRAP constabulary that requires abortion providers to meet the standards that apply to ambulatory surgical centers fifty-fifty though these centers typically provide more invasive and risky procedures than abortion and use higher levels of sedation than unremarkably provided in abortion clinics.

Arkansas, Indiana, Ohio and Oklahoma made existing requirements more stringent.

• Indiana expanded its existing requirement that surgical abortion providers meet ambulatory surgical middle standards to also include facilities that provide only medication abortion. 20-4 states crave abortion providers to meet such standards (meet Targeted Regulation of Abortion Providers).
• Oklahoma adopted a measure out allowing for unannounced and warrantless inspections of ballgame providers; enforcement of the provision is blocked pending a legal claiming.
• A new Ohio law requires abortion providers to exist within 30 miles of a hospital with which it has a formal transfer agreement (permitting the transfer of patients needing emergency care) and automatically denies clinics' requests to waive provisions of the state's TRAP law if not approved past the state Health Department within sixty days.
• Arkansas approved a measure out requiring physicians who administer medication abortion to take a contract with some other physician, who has admitting privileges at a local hospital, to handle emergencies, making it the just state to accept such a requirement that applies but to providers of medication abortion. Five states require all abortion providers to have admitting privileges.
• Arkansas and Indiana adopted measures mandating specific and costly requirements for the disposal of tissue following an abortion. The Arkansas police force requires the tissue to be handled in a "respectful and proper manner." The new police force in Indiana requires the tissue to be either cremated or buried in a cemetery.

Family Planning Providers

In the backwash of the release of a series of deceptively edited sting videos aimed at Planned Parenthood, attempts to defund the organization accept flared at both the federal and land levels. Past the end of 2015, some 11 states had moved to slash funding either for Planned Parenthood health centers specifically or for any family planning provider that also offers abortion services. A Guttmacher analysis shows that defunding Planned Parenthood could seriously impair women'southward access to needed services: In 2-thirds of the 491 counties in which they are located, Planned Parenthood health centers serve at least half of all women obtaining contraceptive care from safe-internet health centers. In one-5th of the counties in which they are located, Planned Parenthood sites are the sole safety-net family unit planning middle.

States take targeted a diversity of funding streams on which family planning providers rely to fund the breadth of their services and activities, and are likely to proceed in this vein in the upcoming 2016 legislative sessions:

• Medicaid

Mirroring events in Congress, v states—Alabama, Arkansas, Louisiana, Oklahoma and Texas—took steps to exclude Planned Parenthood from the Medicaid program in 2015. These efforts were blocked by federal courts in Alabama, Arkansas and Louisiana; a challenge was just filed in Nov in Texas. (The initial Arkansas ruling applied only to the iii Medicaid enrollees named in the arrange; efforts are underway to aggrandize that injunction to all enrollees in the state.) Similar efforts made past Arizona and Indiana in contempo years were also rebuffed by federal courts.

• Other Family Planning Funding

Following the release of the videos, N Carolina expanded its existing provision blocking state funding of "non-public" family planning providers to explicitly apply to family planning providers that also offer abortion services. (Similar measures to bar funding for family planning providers that offer abortion care were introduced in Illinois, Pennsylvania and Wisconsin.) In add-on, New Hampshire'due south Executive Council, an administrative board charged with overseeing large funding streams in the state, excluded Planned Parenthood health centers from receiving federal Title 10 dollars that flow through the state. (Title X funding that Planned Parenthood receives straight from the federal regime is not affected.)

Ten states limit eligibility for family planning funding (see Land Family Planning Funding Restrictions). Viii of these states—Arizona, Arkansas, Colorado, Indiana, North Carolina, Ohio, Texas and Wisconsin—prohibit abortion providers from receiving state family planning dollars. Kansas and Oklahoma exclude family planning providers non operated by public entities from eligibility.

• Funding for Related to Services and Activities

N Carolina and Utah moved to exclude family planning providers from eligibility for funding for related services. Legislation enacted in North Carolina bars family unit planning providers that offer ballgame services from receiving funding for adolescent parenting and teen pregnancy prevention programs. Utah Gov. Gary Herbert (R) directed the state section of health to discontinue whatsoever funding for Planned Parenthood health centers, including funding for STI surveillance efforts, STI testing and treatment and abstinence education; a federal appellate court recently barred the state from excluding Planned Parenthood from the funds.

Fetal Tissue Donation and Enquiry

As yet another outcome of the release of the Planned Parenthood sting videos, 10 states moved to regulate either the process for fetal tissue donation or biomedical inquiry conducted in the state using fetal tissue resulting from induced abortions. Fetal tissue inquiry has been integral to many of the major medical advances of our age. For example, fetal cell lines were used in the development of the polio vaccine, a breakthrough for which the 1954 Nobel Prize in Medicine was awarded. In addition, vaccines for diseases such as measles, mumps, rubella, chickenpox, hepatitis A and rabies were all created using cell-line cultures originating from fetal tissue. In curt, fetal tissue research has saved and improved the lives of millions of people worldwide.

During the final months of 2015, Due north Carolina and Arizona moved to regulate fetal tissue donation and enquiry. A constabulary enacted in N Carolina prohibits the sale of fetal tissue for a turn a profit, paralleling federal requirements. Arizona adopted an emergency regulation requiring facilities to written report any donation of fetal tissue to the land. Measures related to fetal tissue donation and enquiry were introduced in Alabama, California, Michigan, New Jersey, Ohio, New York and Wisconsin.

Explore current state laws and policies on sexual and reproductive health topics.

Get an overview of state legislative and policy activeness ​to engagement.

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Source: https://www.guttmacher.org/laws-affecting-reproductive-health-and-rights-2015-state-policy-review