Busy day in Concord starts with end-of-life bill

End-of-life; smoothing the way for telemed abortions; making oral contraceptives available over the counter (and maybe undercutting the HHS mandate on the way); demanding transparency from insurers: welcome to Tuesday at the State House in Concord. Hearings will begin this morning on these bills.

HB 151:  establishing a committee to study end-of-life decisions

In 2013, Governor John Lynch vetoed a bill to set up a committee to study “end-of-life decisions.” The bill had originated as a straight-up assisted suicide bill before being amended into what the sponsor hoped would be a noncontroversial baby step forward. I noted at the time that Rep. Robert Rowe was not fooled. He spoke to his colleagues briefly and forcefully during the floor debate, saying “The total thrust of this bill is euthanasia.”

New session, new sponsor: House Bill 151 has been brought forward by Rep. Larry Phillips (D-Keene). The bill has no co-sponsors at this time. Rep. Phillips wants to commission six state representatives and one state senator to study end-of-life decisions, with the bill to become effective upon passage and a committee report due November 1.

The committee, should it be formed, would be tasked with (but not limited to) “investigating the positive and negative effects of legislation in states that have enacted aid in dying laws, innovation practices of other states, specifically Minnesota, Wisconsin, and California, how to encourage careful and responsible deliberation about this complex and emotional issue, and any other matter the committee deems relevant to its objective.

Rep. Rowe had it right in 2013. His words are just as apt now.

SB 36: making oral contraceptives available without a prescription

This one comes from Senator Andy Sanborn (R-Bedford). Interesting. I had two thoughts when I heard about this bill: Culturally, it’s wretched. Politically, it has one potential good effect: it could weaken the Obamacare contraceptive mandate.

If oral contraceptives are available without a prescription – behind the counter, under the terms of Sen. Sanborn’s bill, rather than over the counter – they won’t be covered under anyone’s health insurance prescription drug plan. Anyone wanting to consume an oral contraceptive would pay for it herself, or receive it under a Title X family planning subsidy. That’s how things stood before August 2012, when the creaking leviathan known as Obamacare began imposing what was then known as the HHS mandate.

Obamacare classifies suppression of female fertility as a public-health priority, to the extent of treating it as “preventive care.” We are all therefore mandated to pay for it in our health insurance plans, and most business owners are required to include it in any health insurance plan offered to employees, irrespective of religious beliefs about the immorality of contraception and abortion-inducing drugs. Remember, the Hobby Lobby case was very narrow. Many other Americans are still in court defending their right not to pay for someone else’s contraception.

If SB 36 were to pass, it wouldn’t affect shots or implants or IUDs. The contraceptive mandate would still exist, as long as there’s public policy in place that treats women’s fertility as something to be prevented. Title X would still exist, with tax-funded block grants going to states for “family planning” excluding surgical abortion.

I wonder what non-prescription birth control pills would mean for agencies like Planned Parenthood. Is it safe to assume that the cost of the drugs would go down, if they were available without prescription? Would the agencies pass on those savings to clients? Would they not need quite so much Title X money to do the same job they’re doing now? Or would the agencies shift to a medical model relying more on implanted drugs, keeping the mandate as a cash cow?

Let’s see who shows up to testify on this one.

SB 42: relative to employee notification of contraceptive coverage

If SB 42 passes, and if you’re an employer who offers health insurance as an employee benefit, you have to tell your employees about contraceptive coverage and what contraceptives might not be covered.

“Such notice shall be prominently displayed on the face of any written application for employment …[and] where such employer maintains a publicly accessible Internet webpage that provides information on prospective employment opportunities, the employer shall provide clear and conspicuous notice on the webpage as to whether the employer provides contraceptive coverage and, if so, whether such coverage includes some, but not all, contraceptive drugs and devices or their generic equivalent approved by the FDA.”

Fine. We’ll inch toward transparency in our insurance policies even if we have to rely on Hobby Lobby opponents to do it. This bill is sponsored by Senators David Pierce (D-Lebanon) and Martha Fuller Clark (D-Portsmouth), who are fuming at the very narrow victory won at the Supreme Court by the owners of Hobby Lobby, who objected to covering four out of the twenty methods of FDA-approved contraception.

Of course, transparency isn’t the sponsors’ goal here. It’s simply a means to a couple of ends. One end is to embarrass employers who would rather stay out of their employees’ sex lives. Another is to make abortion and birth control indistinguishable and equally desirable under public policy. The owners of Hobby Lobby objected only to helping provide four methods of “birth control” that are known to induce abortions. The Supreme Court OK’d that narrow exception for that one type of business (closely-held). That’s apparently going too far, in the eyes of Senators Pierce and Clark.

SB 84, relative to the definition of “telemedicine”

Telemedicine – the use of electronic media like video conferencing for the purpose of diagnosis, consultation or treatment – is going to be extraordinarily valuable. It holds great promise for mental health treatment, among other things, and mental health treatment was the focus of a New Hampshire study committee on telemedicine. SB 84 has been drafted in the wake of the committee’s recommendations.

A New Hampshire telemedicine law will be just as useful for abortion providers who have been impatient to start dispensing abortion-inducing pills remotely. Telemed abortions are already being done elsewhere in the country. It’s neither good medicine nor good social policy to suppress telemedicine simply because abortion providers want to use it. As with SB 36, though, it’ll be interesting to see who testifies on this one.


Hey – who are you callin’ “marginal”?

What’s a marginal child?  Don’t worry if you can’t quite pin it down. There are scholars on the job. Jonathan Gruber, for example.

Jonathan Gruber (photo: economics.mit.edu)

Mr. Gruber, of stupid-Americans-made-Obamacare-possible fame, is getting his just desserts before a Congressional committee this week. His 15 minutes of fame have prompted some reporters to unearth Gruber’s earlier work. With a hat tip to Breeanne Howe of Red State for bringing this to my attention, I’m looking at a 1997 paper co-authored by Gruber: “Abortion Legalization and Child Living Circumstances: Who Is the ‘Marginal Child?'”, a working paper for the National Bureau of Economic Research located in Cambridge, Massachusetts. (Full text is here.)

“The most important change in government fertility policy over the past 30 years was the legalization of abortion under the Roe v. Wade decision.” Thus spake Gruber et al. in 1997. Of course, since then, Obamacare’s HHS contraceptive mandate has expanded “government fertility policy” (the very phrase makes my skin crawl, but I digress …) by holding that women’s fertility is a disease to be prevented. But back to 1997. Gruber and his co-authors asked if the “marginal child who is not born when abortion access increases more or less disadvantaged than the average child?” “We address the selection inherent in the abortion decision,” they add helpfully.

Here’s my humble attempt to translate their academic query: Is the hypothetical child of an abortion-minded woman better off for having not been born? Are we as a society better off for that non-birth?

Yes, according to the paper’s authors, writing seventeen years ago. “Our estimates imply that the marginal child who was not born due to legalization would have been 70% more likely to live in a single-parent family, 40% more likely to live in poverty, 50% more likely to receive welfare, and 35% more likely to die as an infant. These selection effects imply that the legalization of abortion saved the government over $14 billion in welfare expenditures through 1994.”

Only a policy wonk – or a trio of them – could miss the irony of saying that an aborted child would have been 35% more likely to die as an infant had she been allowed to be born.

Please, read the whole thing. It’s instructive to know what kind of resumé helped Gruber land an Obamacare consulting gig. I am not a statistician and am not in a position to evaluate the data set he used in the 1997 paper. I don’t need to be a statistician, however, to be sickened by the paper’s conclusion.

If abortion saved the government $14 billion between the early 1970s and 1994, just think how much the government has “saved” since then. Simply by marginalizing children, we’re “saving” a fortune.

Want to “save” more money? Marginalize more people. Jonathan Swift is turning in his grave.


What are you doing for health insurance?

Photo: office.com
Photo: office.com

Not a blogging day, except to rant. It’s health-insurance-shopping time. (We’ve all gotten past the keep-your-plan lie, right?)

I want to have some kind of coverage, to insulate my family from possible catastrophic medical costs. I want to avoid Obamacare’s contraceptive mandate. Make that I want to spit in the mandate’s eye. I don’t want to participate in a program that funds elective abortions – and yes, Obamacare funds abortions. I haven’t forgotten September’s Government Accountability Office report.

My choices, as far as I can tell, are these:

  • Buy a plan on the exchange, and cross my fingers that my money isn’t used to pay for someone else’s abortion. There’s no state law here to keep that from happening.
  • Go without insurance and pay the piddling fine. That’s appealing given my income level, but it leaves my family too exposed to catastrophic costs. Also, paying the fine grants a little too much to Caesar, although I’m aware that’s not a settled point among my co-religionists.
  • Enter a health care cost-sharing program like CURO from Christ Medicus. Would I qualify? Can I afford a program that doesn’t cover a pre-existing condition? Of course, in view of the high deductible I’m paying under my current coverage (thanks again, Obamacare), cost-sharing may still be the economically sensible thing to do. It is absolutely the way to go to be sure my health care dollars don’t go to abortion.

This should be a simple matter of dollars and cents, but it’s not. I live in a country where divesting oneself from the abortion industry is becoming well-nigh impossible. I’m going to keep trying.

End of rant. Back to crunching the numbers and discerning the best course.

Readers, what are your thoughts as open enrollment time approaches?

Protecting Obamacare at all costs: Shea-Porter, free pills, and religious liberty

Originally published on this blog October 1, 2013. It remains timely, with Ms. Shea-Porter on the ballot once again next Tuesday.

Congresswoman Carol Shea-Porter (D-NH1). Facebook photo.
Congresswoman Carol Shea-Porter (D-NH1). Facebook photo.

On the How They’re Doing in D.C. scoreboard, I hereby give a point to Congresswoman Carol Shea-Porter for answering her mail promptly. I then deduct ten for the content of her message.

As a resident of New Hampshire’s First Congressional district, I emailed Shea-Porter as a “government shutdown” loomed, involving funding for the president’s health care law. I told her that voting to fund government operations while withholding funding from Obamacare was fine with me. Her reply was in my inbox a few short hours later.

From the desk of CSP

Here’s the relevant portion of her message. I’ve added some bold-face emphasis.

“Last weekend, the House of Representatives voted on a Continuing Resolution that contained multiple provisions that had nothing to do with keeping the government operational. That version of the bill, which I voted against on September 29th, included a provision that would allow any employer or insurer to refuse to cover any health care services they might object to.  This would give unprecedented control over personal healthcare decisions to employers and insurers, allowing them to deny coverage for important women’s preventive health services, including HPV testing to prevent cervical cancer, domestic violence screening and counseling, and birth control.”

Like the president whose water she’s carrying, she conceded no good will to people like me who see the down side of the “Affordable” Care Act. That makes her next sentence a punch line, albeit a lousy one.

“I stand ready to work with my Republican and Democratic colleagues on finding common ground and getting things moving here in Washington.” 

I guess the First Amendment doesn’t qualify as common ground.

One of these things is not like the others … 

Note her email’s smooth blend of HPV testing, domestic violence counseling, and birth control. All are “women’s preventive health services,” according to Shea-Porter, reading from the HHS playbook. That term is the source of the HHS mandate, that outrage against the First Amendment, beside which Obamacare’s other flaws pale in comparison.

When the Department of Health and Human Services came up with regulations (in excess of 15,000 pages so far) to enforce the ACA, it defined certain “preventive” services required to be included in every health insurance plan. Those preventive services are to be provided at no cost to a covered individual, meaning no co-pay, meaning in turn that the costs are actually shared by everyone enrolled in the plan.

HPV testing is a way to monitor for cervical cancer (although it can’t prevent it, contrary to what CSP wrote; perhaps she meant Gardasil injections). So far, so good. Domestic violence counseling can prevent injury to women. Still good, although it is a puzzle to me why such counseling isn’t classified as preventive service for men as well. And that brings us to the third example of a “preventive” service cited by my congressional representative: birth control for women. It can prevent pregnancy, which under the psychedelic terms of the ACA is right up there with cancer and violence on the list of Things To Be Prevented. Men’s fertility doesn’t rate the same level of caution under the law.

My religion, among others, holds as an article of faith that human life is sacred and that fertility is not a disease. There is a sharp and clear line between contraception and health care. Further, my religion holds that contraception and abortion-inducing drugs are not only not health care but are evils to be rejected. A law that mandates that I help provide those things for other people, on pain of fines or other sanctions, is therefore an attack on my First Amendment right of religious liberty. This is true whether I am acting as a private individual or as a business owner.

If only the President and Secretary Sebelius hadn’t insisted on that “preventive” designation, we wouldn’t be having our disagreement. Up until that mandate, I had no constitutional problem with my neighbor buying her own birth control pills, since she didn’t reach into my pocket for help paying for them. Under Obamacare, such a live-and-let-live attitude is no longer consistent with public policy. In the President’s world, as in Shea-Porter’s, free birth control for women is on the same level as caring for my sick child or my ailing elders.

“Unprecedented control”

In Shea-Porter’s view, it’s imperative that employers with religious objections to contraception be forced to subsidize it anyway. She thinks that affording such people freedom of conscience would amount to “unprecedented control” over a woman’s health care decisions.

Forcing an employer to pay for birth control pills is an “unprecedented control” of its own.

I take from this that Shea-Porter believes free pills must somehow trump religious liberty. Perhaps I take too dim a view.  HHS Secretary Sebelius, when asked about the HHS mandate last year, couldn’t square it with religious liberty beyond saying, “I’m not a lawyer and I don’t pretend to understand the nuances of the constitutional balancing tests.” Madam Secretary is apparently not the only Washington denizen who has trouble with nuance. The difference between health care and health coverage, between choice and mandate, between cancer screening and fertility suppression: all are lost on my congressional representative.

“Extreme measures”

“We should start by passing a clean Continuing Resolution that funds the government, without attaching extreme measures to defund, delay, or erode the ACA.”

So what extreme measures might those be? Or are all measures extreme that interfere with Obamacare? Is there a moderate measure I can ask for – common ground, if you will – that will persuade Shea-Porter to give the First Amendment its due vis-a-vis the HHS mandate?

There was no time in our brief email exchange to explore those questions. I suspect she considers all opposition to ACA “extreme,” but again, I may be taking too dim a view.

This I know: the HHS mandate seeks to make every American complicit in the suppression of women’s fertility as a public health priority. Free pills on the house, so to speak. That’s extreme.

The shutdown

My email from Shea-Porter came just a short time after President Obama claimed “The Affordable Care Act is moving forward….[it] is a law that voters chose not to repeal last November.” Voters who stayed home last November 6, for whatever reason, have much to answer for. But here we are.

The government is “shut down” as I write, meaning no PandaCam or hikes in Yosemite, although the microphones in Washington seem to be operating at full power. Each party blames the other.  As an independent voter, I am weary of that. What is absolutely clear to me is that Obamacare partisans like my congressional representative are fully committed to putting the HHS mandate ahead of every other priority in the budget.

In her email, Shea-Porter defended the HHS mandate without calling it by name. She added insult to injury by ignoring the good faith of people who have religious objections to it. She professes the Catholic faith, as do I. She is following her conscience without recognizing my right to follow my own.

I’ll support any measure that forces reconsideration of Obamacare. Its carveouts are unacceptable; it chills expansion of small businesses; its early cost estimates are already looking ridiculously low. Any one of those issues should be enough to trigger delay and reappraisal. Important as they are, none of those flaws are as bad as the HHS mandate. It must be torn up, thrown out, disavowed. I refuse to choose between health care and the First Amendment. I want them both and I won’t settle for less.

Not forcing you to look, Senator(s)

I’m warning you up front: I am NOT forcing you to scroll down to the bottom of this page. Nope. Not me. I will NOT force anyone to see the image that New Hampshire’s senior senator finds so scary. This is, after all, a kinder, gentler blog than the kind in which you’ll find abortion advocates described as “bat-guano crazy.” “Crazy” is such a freighted word. No, I’ll just NOT force you to scroll down.

I laughed through heartache yesterday as candidate Scott Brown stopped just short of jumping up and down and saying “I am TOO!” to Jeanne Shaheen’s claims that he just ain’t pro-abortion enough. Excuse me, “pro-choice.” He had the unmitigated gall to support an informed consent bill in the Massachusetts legislature back in 2005 when he was just a wee lad. He apparently thought then that pro-choice and pro-information were perfectly compatible positions. Makes sense to me. Not to abortion advocates, though.

Shaheen has an ad out now – the one to which Brown was objecting yesterday – announcing in dark tones that Brown would “force” women to look at fetal pictures, since part of the Massachusetts informed consent bill would have required that abortion providers give a woman the opportunity to take a look at images conveying the size, formation and gestational age of her fetus (has a tender ring to it, no?) before proceeding with termination of said fetus. Not bloody baby pictures, mind you. Not, in spite of Shaheen’s claims, forced viewing. Just providing the images for a woman to consider. Informed consent. Get it? This reminds me of the inserts we all get when we have prescriptions filled. Show of hands: how many of us actually read all that verbiage? That’s what I thought. Just give me the medication. The pharmacist and the prescribing provider OWE me full information about the drug. They just can’t make me read it. Informed consent, not forced viewing.

Shaheen knows she would sound like a patronizing schoolmarm if she were to suggest that women are too delicate for such intimate self-knowledge as knowing what’s inside our uteruses, so she is resorting to accusations that Brown is somehow anti-woman. This is all of a piece with the Senate Majority PAC’s ad saying “Scott Brown will restrict women’s access to health care” because he is not in favor of compulsory universal taxpayer funding of abortion.

Hence the spectacle of Brown fighting back. In one sense, good for him. He’s the only high-level Republican candidate in New Hampshire this year who has hit back on way-out-there claims by abortion advocates. Right attitude, even if he has the wrong answer. He’s out there, just not way out there, is what I hear him saying. He knows that for a woman concerned about access to abortion, jobs-and-the-economy is just a diversionary squirrel.

This is a defensive election. Neither of New Hampshire’s major candidates for U.S. Senate is pro-life. Incumbent Shaheen needs to be retired, though. I won’t leave that spot on the ballot blank, and I’m not writing in anyone. I don’t want to explain to anyone how a woman opposed to informed consent and in favor of compulsory universal taxpayer funding of abortion got elected yet again. She’s pro-women’s health? I don’t see it. Pro-women-who-agree-with-her is more like it. She wants abortion providers to operate in a regulation-free environment; you may recall that as governor she signed repeal of New Hampshire’s antiquated nineteenth-century abortion laws, knowing that nothing was there to replace them. In perhaps the sharpest distinction between her and Brown, however, she opposes the conscience rights of individuals (including female business owners) who don’t want to be forced into helping provide abortion-inducing drugs and devices under Obamacare. And then there’s her contempt for Catholic women who take issue with being forced to pay for other women’s contraception. Out, I say.

Look at it this way: in New Hampshire, I could set up shop as an abortion provider, right in my own home. (If Kermit Gosnell ever gets out of prison, he could go right back to his butchery just by moving from Pennsylvania to the Granite State, and he wouldn’t even have to rent an office.) As long as I didn’t hold myself out as a medical professional, I’d be clear of fraud accusations. As long as I had an abortion-minded woman’s permission to perform the abortion, I’d wouldn’t be subject to assault charges. It would be nice if I had a clean environment for her, but if she said she didn’t care about anything but ending her pregnancy, I’d be off the hook. Disgusting, but that’s the law. Nothing in New Hampshire law says an abortion provider has to be qualified in any way. Medical professionals who provide abortion must answer to state boards and medical societies, but non-professionals don’t. Women’s health? Abortion  providers, amateurs and pros alike, enjoy protection that abortion-minded women are denied. Don’t blame me. This is Shaheen’s doing, and it’s been ratified ever since by legislators who have rejected informed-consent-for-abortion laws.

Scott Brown has no trouble with any woman who wants to abort. He just thinks – or at any rate he thought in 2005 – that women have the right to know what’s involved.

The 2005-vintage Brown wasn’t afraid to offer images like this to abortion-minded women. Those women would have been free to say “no” to the offer, under the Massachusetts bill that has Shaheen in such a snit.

Human fetus, 7 weeks. (Priests for Life photo)
Human fetus, 7 weeks. (Priests for Life photo)

Scary as hell, isn’t it? Scarier. That little image could stand between Jeanne Shaheen and her next term as Senator. No wonder she wants it kept out of view.