NH stats study committee recommends “future legislation”

A legislative committee has agreed that New Hampshire needs a law requiring collection of abortion statistics. Now comes the fun part: passing one.

The interim study committee examining House Bill 1502 from the 2014 New Hampshire House session issued its brief report on November 14. Representative Laurie Harding (D-Lebanon) wrote on behalf of her colleagues on the Health, Human Services and Elderly Affairs Committee:

The committee voted in favor of future legislation that is focused on meaningful, confidential collection of abortion statistics only for the purpose of public health analysis and intervention. The data would be summarized and made public in an aggregated form. The committee supported the motion to recommend future legislation only if the data collection is guaranteed to protect the anonymity of the provider and patient and the appropriate resources are available. (Vote: 16-1)

Interim study reports are non-binding but influential on future legislative action. The next time an abortion statistics bill comes up, this recommendation will be used somewhere along the line as a point of reference, particularly since many of the people on the study committee were re-elected a couple of weeks ago.

As it happens, Rep. Kathy Souza (R-Manchester) has filed her intent to introduce a statistics bill in the session beginning in January. Souza is strongly pro-life. You can bet she’s going to do her best to keep this needed legislation from going off the rails.

Off the rails? Yes, it could happen.

I attended several of the study sessions on HB 1502. The consensus of the committee, dominated by abortion defenders, was that statistics were a good idea to the extent that they might help identify populations currently underserved by contraception providers. (No wonder PPNNE stopped objecting to the bill. From their standpoint, a stats law would be market research at the state’s expense.) One needn’t track post-abortion morbidity and mortality to get at that information. Another point of consensus was explicitly written into the interim study report: abortion providers should remain anonymous. So much for women’s health.

It’s true that any statistics law will be a step in the right direction. New Hampshire public health authorities have no official idea how many abortion providers work in New Hampshire, or how many women and girls get abortions, or how many of those abortions are late-term surgical or early-term chemical. Any effort to fill in those gaps will be a public health boon. Let’s take it further and pass a law that tracks how women fare after abortions, at least to the extent that a provider who consistently had awful outcomes could be identified and stopped.

The text of Souza’s bill is at least a month away from being ready for release. It’ll be interesting to see how it’s received by the colleagues who have just said there oughta be a law.

 

NH statistics bill study begins

True to the word of several legislators who spoke up earlier this year – and I have to admit I doubted them – the abortion statistics bill, HB 1502, is actually getting interim study and not the shredder. A subcommittee of the House’s Health, Human Services & Elderly Affairs committee convened yesterday for a 45-minute work session, with another one scheduled for June 10. The bill’s chief sponsor, Rep. Kathy Souza (R-Manchester), was there to listen and to take questions as they came up.

Collecting statistics is a good thing, especially starting from zero information. The tone of yesterday’s session, though, made it clear that interim study is going in a direction somewhat far afield from what this supporter of HB 1502 expected.

What would statistics be for?  Not what you might think

The first person invited to speak by subcommittee chair Rep. Laurie Harding (D-Lebanon) was Kathryn Frey of the state’s division of public health services. Frey indicated how her department sees abortion statistics: “This is all about promoting planned, healthy pregnancies.”

Oh. Women’s health? Not so much.

Back to “planned, healthy pregnancies”: if statistics were to show a high rate of unplanned pregnancy, that would show the state and its contractors where to push contraception. Much of that would probably come at taxpayer expense via Title X. No surprise that the session was attended by a representative of New Hampshire’s #1 Title X contractor, Planned Parenthood of Northern New England.

Complication rates: “that’s not a goal here”

There was discussion on the privacy of data, with all parties to yesterday’s discussion agreeing that patient confidentiality must be protected. Rep. (and Dr.) Thomas Sherman (D-Rye) mentioned that he doesn’t want providers identified, either.

Does that mean that the state wouldn’t be able to figure out who’s having untoward complication rates among her or his abortion patients? Sure sounds that way.

Dr. Sherman added, “To start reporting complication rates [for abortion] in the state of New Hampshire, is to take it beyond any other procedure, and single it out. On the other hand, there is a clear public health interest – and this is what I was trying to get at with the original data question – is there a place where this is happening more, are there public health interventions to decrease the rate of abortion statewide? But I for one would strongly oppose taking a procedure, one that is legal here, and singling it out for extra scrutiny when the knowledge is already there. What is the national rate of complications associated with abortions? We do know that.”

One listener, a woman who traveled from Gilford to listen to the subcommittee, asked aloud where that information could be found. I myself wondered about Dr. Sherman’s reference. Is he talking about the data that the CDC admits has “limitations” because of the incomplete and voluntary national reporting? Or maybe data from the Guttmacher Institute, a former arm of Planned Parenthood?

Rep. Harding intervened at that point. “The goal of this conversation is to figure out how we can collect the data on abortion so that we can provide some better public health interventions. I think that some of the issues [about] any kind of side effects or any kind of mishaps related to abortion is – as Rep. Sherman said – usually dealt with by the individual board of licensing for a physician or practitioner. But the goal of this conversation’s got to be data collection for public health.”

Rep. Souza had some news for the subcommittee at that point. She thumbed through a thick file of abortion reports from other states.  “I happen to have in front of me several other states- it’s Oregon, Minnesota, Oregon, some others – that actually do ask for that [post-abortion complications]. There may be familiarity with this from other states.” She pointed out the template the CDC recommends to states for abortion reporting, with a place to note complications.

Rep. Harding was not about to go there. “And the focus of the CDC is of course on public health. So, you know, I’m pleased that we’re having this conversation. I think we really need to focus on where we all agree, and moving forward on some of this.”

Aggregate data vs. individual records: PP’s concerned

There was much talk about keeping individual records in state hands, protected by confidentiality laws, if an abortion statistics law were to be in place. Stephen Wurtz of the state’s vital records office noted “We’re held to a higher standard than HIPAA,” the federal medical-record privacy law. The state could then take those individual reports from abortion providers, with no personally-identifiable patient information, and create an aggregate statistical report.

PPNNE’s representative, Jennifer Frizzell, demurred. She suggested that PP could aggregate its own records and then submit information to the state.

Is that how the state’s cancer registry works, I wonder? Is that how any hospital reports things to the state? I honestly don’t know. Sounds a little odd to me.

Early in the process

Rep. Harding, whose manner is always gracious, took the time at the beginning of the session to explain the interim-study procedure to the citizens in the room who weren’t lobbyists or legislators: HB 1502 will actually “disappear” in favor of a new bill, drafted with the subcommittee’s report at hand, if anyone chooses to introduce such legislation in 2015. The subcommittee is gathering information from interested parties, and will formulate recommendations for future action on that basis.

In other words, nothing’s final yet. Good to know.

Earlier posts on HB 1502 and abortion statistics: NH Reps meet resistance to stats bill, Putting down a marker for women’s health, How to lie with statistics