State of Sexual and Reproductive Health and Rights: 2018 Year in Review

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Over the past year, sexual and reproductive health and rights have endured unending attacks from the administration, Congress, and state legislatures. This year, women and girls around the country have watched as access to vital reproductive health services and funding have hung in the balance. Jacqueline Ayers with Planned Parenthood reviews 2018 with us, and talks through the ups and downs of SRHR this past year.

As always, attempts to defund Planned Parenthood were ever-present in 2018. In fact, Paul Ryan stated that one of the first acts of the 115th Congress would be to dismantle the Affordable Care Act and defund Planned Parenthood. The administration-run Department of Health and Human Services also encouraged states to try to limit funding to Planned Parenthood by preventing their health centers from participating in the Medicaid program.

Title X, the nation’s historically bipartisan federal program dedicated to birth control access, also served as tool for those insistent on attempting to block access to reproductive health care. The administration attempted to drastically change the program through a funding alteration, as well as creating a new rule that barred providers from giving abortion-related information to their patients. This proposed new rule is known as the domestic gag rule.

1 in 5 women rely on Medicaid as their source of healthcare. Efforts to dismantle Medicaid simultaneously stigmatize the working poor and create unnecessary barriers to accessing vital healthcare.

There have been endless attacks on access to birth control. A leaked memo in May of 2017 revealed plans to roll back the ACA’s extremely popular birth control mandate, and in October, the administration created a rule that would allow employers to opt out of providing birth control coverage on their insurance plans for religious or moral reasons.

This year, we have also seen a proposed rule which would allow an entity to refuse healthcare (including transgender care, birth control, abortion care, etc.,) based on religious or moral beliefs. This rule has not been finalized, yet. HHS also announced the creating of a new “Conscience and Religious Freedom Division” within the HHS Office for Civil Rights, which would protect health workers from repercussions of refusing care that goes against their religious beliefs.

There has been an unfortunate attempt at censorship surrounding SRHR issues. This year, the Center for Disease Control and Prevention and the U.S. State Department have refrained from using phrases like ‘sexual and reproductive health care.’

The Teen Pregnancy Prevention Program, meant to provide comprehensive sex education to young people, has also been under direct threat. The administration has pushed ‘sexual-risk avoidance,’ or abstinence-only education. This program, under the current administration, has not been based in science nor LGBTQ+ inclusive.

The good news is that, so far, we haven’t lost a lot of the progress that we have made. The Affordable Care Act is still in place, the birth control benefit still exists, Planned Parenthood is still funded and Medicaid hasn’t been dismantled. Still, there will be many more attacks on sexual and reproductive health and rights, and it is important to be prepared!

Links from this episode

Planned Parenthood
Planned Parenthood Action Fund
Planned Parenthood on Facebook
Planned Parenthood on Twitter
Planned Parenthood Action Defender
Tracking Trump

Transcript

Jennie: Welcome to rePROs Fight Back a podcast on all things repro. I'm your host Jennie Wetter. In each episode, I'll be taking you to the front lines of the escalating fight over our sexual and reproductive health and rights at home and abroad. Each episode, I will be speaking with leaders who are fighting to protect our reproductive health and rights to ensure that no one's reproductive health depends on where they live. It's time for repros to fight back.

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Jennie: Welcome to rePROs Fight Back. Happy New Year, and I hope everybody had a wonderful holiday. Since this week's episode is coming out on New Year's Day. It seemed like the perfect time to do a year in review, kind of looking back at all the many things that have happened over the past year, so I couldn't think of a better person to talk to, to, to break that down than Jacqueline Ayers from Planned Parenthood. Um, Jacqueline, Hi. Thanks for being here.

Jacqueline: Hi thank you so much for having me in a year. Right? What a amazing time to look back at where we've come from.

Jennie: Yeah, it was a little shocking. Like, you know, a lot of things have happened, but like looking back at kind of the full list and it was a lot.

Jacqueline: Absolutely. The last two years have been an unrelentless attack from the congress, from the administration. Um, and I think, uh, now as we enter into 2019, uh, we have some bright spots to look ahead to.

Jennie: Yes. So I've definitely, I've added that to the end cause I figured this otherwise it'll be pretty negative. We need to focus on, one, looking forward, but two, there are some bright spots when we think about looking forward. So, um, because there were so many attacks, um, we broke them down into types, which I think was super helpful. Um, so first one of the types of attacks was trying to block access to getting care at Planned Parenthood.

Jacqueline: Yeah. I mean, I recall the beginning of the115th Congress then Speaker Paul Ryan and said, hey, we're gonna, uh, one of our first acts will be to, uh, dismantle the Affordable Care Act and Defund Planned Parenthood. They entered with a straight agenda, and spent really all of 2017 attempting to do that. And soundly failed because so many people did speak out. And then in 2018, we saw more actions happening from the Trump administration and Health and Human Services Department where they encouraged states to try and Defund Planned Parenthood, so-called, by preventing health centers, uh, from participating in the Medicaid program. So we saw state after state put forward waiver requests asking the administration to basically kick Planned Parenthood out and treat Planned Parenthood differently than any other healthcare provider, um, by not allowing Planned Parenthood to get reimbursements under the Medicaid program. Um, so here we are two years into the Trump/Pence administration and we have yet to see the congress be able to achieve that goal. Uh, and so far, uh, we're still waiting to see what will happen with waivers from various states like Texas and South Carolina. Um, and we know that they're going to continue to also try and push this in the courts, which we see in many states try to do. So a lot has been accomplished. But, uh, that, uh, main agenda item of conservative and anti reproductive health, uh, or, uh, efforts have not gone away.

Jennie: And I think it's really important to kind of flush that out just a tiny bit. Cause I feel like people often here we need to defund Planned Parenthood and they don't really understand what that means. And I think you kind of gave a good flag to that is it means that patients on Medicaid would not be able to go to Planned Parenthood as their provider. And I think people don't necessarily understand that that's what that means.

Jacqueline: Yeah. I mean, if you're a low income individual who relies on Medicaid to get your health care, you actually have a protection in the law that says you can go to your provider of choice. Any willing provider that participates in the program, the patient gets to decide. These mean-spirited efforts both in Congress and from state laws are really targeting and taking away the ability for low income individuals to go to the healthcare provider of choice. If Planned Parenthood is your provider of choice, these unfair efforts would say, uh, you cannot get a re the healthcare provider, Planned Parenthood health centers would not be able to get reimbursed. Um, and so that means that people would lose access. Uh, we all know that, uh, individuals, uh, if they can't find a provider or another provider, um, they instead of, uh, you know, traveling or going other places, what they'll do is ultimately just go without care. Uh, we saw this, uh, in 2017 when Congress tried it. Um, we, uh, had a lot of information out there about what are the alternatives, where are, there are places people can go. I think one of the myths you frequently hear is just attend a community health center. You'll go and get your care to community health center. Uh, and fortunately there've been a lot of local community health centers across the country who stepped up to say, wait a minute, actually, we refer our patients to a Planned Parenthood health center, uh, to get, uh, the best accurate, full range of, uh, FDA approved methods of contraception, um, for expertise in reproductive health care. And, uh, even other providers have said, hey, we need Planned Parenthood health centers to participate so that the whole network, uh, for care really will work. And, um, thankfully, uh, it, they weren't able to do it in the congress. Um, and for 2019, uh, we know that their efforts have been completely stopped because of the outcome of the midterm elections.

Jennie: I always found it, um, funny, not in a really funny way, but in a, you laugh so you don't cry a kind of way where they would release the lists of, hey look, these are all of the federally qualified providers that women can go to instead. And it's like a dentist and I feel like Florida had one and it was like a prison. And like...

Jacqueline: I've seen libraries on those lists.

Jennie: These are not places where you're going to go to get reproductive health care. Like it boggles my mind when you always see these lists call out for that.

Jacqueline: Yeah, it is really ridiculous because it just shows how to touch these elected officials are with how people live their lives, how they get health care. Um, the reality is is that most women of reproductive age are going to their ob Gyn or a Planned Parenthood health center or other reproductive health care provider as their main source of health care. Um, because typically those are the places where you get a well woman exam, uh, access to birth control, um, cervical cancer screenings, STI testing, and, uh, annually that's the kind of care that young women are most likely to seek. Um, when politicians answers to them is to attend a dentist or to go to a library, I think it just really shows that they're out of touch, uh, and, uh, that they don't really understand the reality of people's lives and how they need to get health care.

Jennie: Um, one other place where we saw attacks on, um, blocking care at Planned Parenthood was with changes to Title X. Do you want to touch on that a little bit too?

Jacqueline: Yeah, Title X is a 48 year old federal program. It's the nation's only federal program, really dedicated to a birth control access and, uh, has been bipartisan. Uh, it's, uh, unfortunately, uh, not been fully funded for years and years. But, um, it has been supported in the congress and in the administration. And then unfortunately, when we had the Trump/Pence administration entered, um, we saw in 2018 that they, uh, attempted to put forward a couple of things, a funding announcement that would have drastically changed the program and also a regulation, uh, that would have said providers are not allowed to give full information to their patients. Uh, particularly about abortion. And this has been, uh, known and read about in the media a lot as the domestic gag rule. Um, that's a regulation that we're still waiting to see could be finalized very early January, 2019. Uh, this is essentially unfair and discriminatory. It would block providers from being able to give their full information to their patients about the best source of their care. Uh, we anticipate that this is like exactly the kind of regulation that the new Congress, uh, particularly a new House of Representatives that will be pro reproductive health care, uh, can speak out against, can take action against, um, and we are going to continue to need people, um, to lift their voices up just like they did in 2017. Um, this is essentially a regulation, uh, for the Title Xfamily planning program that is targeted at reproductive health care providers that also provide abortion. And this regulation has said not only can you not give full information, uh, it also would prevent, uh, health care providers from being located in the same entity where you provide family planning care and abortion care. This is a section of the regulation called physical separation. So, um, it's really detailed and technical. Uh, ultimately what it would mean is the Trump/Pence administration is trying to drastically change the Title X family planning program and it would result in less people having access to care.

Jennie: Yeah. And again, it's just trying to separate abortion from other healthcare.

Jacqueline: Reminding that abortion is healthy.

Jennie: Right, exactly. And that abortion is healthcare. And it's part of reproductive healthcare and trying to separate them as only harmful to women.

Jacqueline: Absolutely. Again, I just keep thinking about the fact that, um, the reality of how women live their lives means that they need to be able to take care of the families and the children that they have and also, um, if they need abortion, they have that ability to get the care they need to keep, continue their education and continue working. Uh, this is a really a mean spirited and it's designed to discriminate against women and others who may need abortion care, uh, by separating at out stigmatizing abortion, making it seem as though somehow all providers shouldn't provide information about this critical healthcare service. Um, uh, really this a domestic gag rule. Um, folks may be more familiar with it because we've seen it on the international scale for years and years with the global gag. Um, those are the kinds of policies that they're trying to bring a here domestically. And if you know, this rule goes into effect, I think we'll start immediately to see health centers impacted and patient's lives impacted.

Jennie: That's what you really are starting to see a lot is things getting tested on the global space and then being brought back domestically and a little bit both ways, right? Things that we're seeing them try domestically are getting pushed out globally.

Jacqueline: Really, it's been a interesting to see that whether we're talking about access to reproductive health care here in the United States or abroad, uh, the agenda is still the same. Um, the Trump/Pence administration is looking, uh, po programs led by the Department of Health and Human Services programs at the US State Department, and they're applying the same tricks, uh, across the globe, uh, to gag people from getting full, uh, information, uh, to try and sensor people. Uh, and ultimately, uh, just push, uh, really what is a really unpopular agenda, uh, when you're talking to just the average of people. But unfortunately, um, the politicians and the administrators who sit at these, uh, agencies and the Trump/Pence administration are too often really not driven by outcome and thinking about what it means for patient care. Um, we know these anti-abortion, uh, very conservative and hate groups that are behind these are looking to spread these policies both in the US and around the globe.

Jennie: So that kind of leads us into the next kind of bucket of issues, which is basic attacks on the health care system. Um, there've been a number of various attacks in that area from um, having state, uh, work requirements on Medicaid, um, to the new finalized birth control rule to the, um, proposed public charge.

Jacqueline: Um, yeah, thank you for lifting it up because, uh, the rate at which as in 2018, we saw new regulations coming out from the Department of Health and Human Services has been a lot to keep up with. Yeah, it's been a lot of, um, uh, being thrown at us all at one time. But really, as you said, it's under the same, uh, efforts, which is to dismantle health care. Um, the Trump/Pence administration has given an indication out to states that they could drastically change their Medicaid program, uh, for the first time requiring Medicaid work requirements. Um, and the Medicaid program, we know one in five women actually rely on Medicaid as their source of health care. So, uh, these efforts stigmatize, uh, the working poor, uh, making it seem as though the, uh, low income individuals are relying on these programs are not currently working. Uh, so putting misinformation out there about them, uh, and also serve as barriers sometimes for people who are going to school, um, who have, uh, other things, um, that they may be pursuing and not able to work the required hours that is being proposed in states. All over the country, we've seen states putting up these efforts, but it's important for I think everybody to know these efforts to dismantle Medicaid are not just about the work requirements. These many of these same states are also saying, uh, that they would like to advance a rule where Planned Parenthood health centers could not be reimbursed. And so when you think about a state that has a work requirement that kicks certain providers out of the program, um, for the individuals living in those states, they just erected so many barriers that essentially health care access, even if you have coverage, uh, being able to access and get the care you need, it could become impossible. Uh, and so yeah, I mean, I think a lot of people, uh, no, and we saw in 2017 Medicaid is a very popular program. Um, we saw people who came out, came to the Capitol who lined, uh, the capitol to prevent Congress from dismantling that program. Uh, but unfortunately not enough attention has been given to the fact that the Department of Health and Human Services is also trying to dismantle that program.

Jennie: That's something you don't hear about as much. Um, especially if you're not really tuned into kind of the health care sphere and it just living your average life, you probably wouldn't hear as much about it until it impacted your life.

Jacqueline: Yeah. I'm from Kentucky and this is a state where we've seen the governor, uh, try to impose work requirements. Thanks to good partners like the National Health Law Program, uh, their efforts, uh, made it stop and temporarily in the courts, um, but as the state has continued to push through and just a matter of months in 2019, we'll see people who have relied on that program for years and years to get their care, and now risk losing that care if, uh, low premiums and continued evidence of work, uh, 20 to 35 hours a week of work has not been proven to the state. Um, too often, as you just said, if you're busy working and taking care of your family, all of the nuances of these regulations sometimes, uh, are complicated and don't make sense to people. Uh, and so unfortunately, I think, and there's been a lot of analysis out there showing, um, in states like my home state of Kentucky and other states where they're trying to pursue these, uh, efforts like, Eh, in Texas, we know that people are gonna lose access to care. And a lot of the progress that we made after the Affordable Care Act, uh, it really is going to be lost under the Trump/Pence administration. So we know that we need more of our, uh, repro fights, uh, back, uh, warriors and people who are speaking up and sharing information, really, uh, to help make sure that people are getting to their elected officials to speak out.

Jennie: I think one thing that has kind of been lost because there's always so much going on at the same time, is the birth control rule getting finalized. You know, there was a lot of uproar when the temporary final rule was issued last year, but it kind of became final with kind of a whimper.

Jacqueline: Yeah. Um, for folks that may not have recalled this, it was like a lifetime ago now, January of 2018, uh, we did see that, um, there was a proposed rule to, uh, allow, uh, an entity to refuse health care, uh, for someone re in particularly a refuse abortion care, uh, transgender health services, but also access to birth control sterilization or really any health care service that a healthcare provider, um, disagrees with based on, uh, their religion. Um, this rule that you're referring to would create really an expansive, expansive enforcement authority. And so what we, what we know is that, um, if a health care official, a doctor or someone you see disagrees with the health care service that you need, um, this rule would allow their religion to discriminate basically on the type of health care that you get. We again, have seen the courts play a big role here, um, in 2018 we know that, um, there, uh, were various birth control rules. The Trump/Pence administration tried to put forward that, uh, two circuits actually stopped, uh, from it going into effect and had a nationwide ban. So that, uh, is good and in place, but we're also still waiting for even, uh, for these more expansive rules that, uh, would undo protections in the Affordable Care Act, and would allow for refusal, a religious refusal rule to take effect in a broad way that could still happen in 2019. So we definitely need more, uh, people talking to their elected officials. And, uh, also now starting to think about how do we get the next and new administration who can start to undo some of some of these things. Um, we know that, uh, this is really, uh, meant to be complicated. The fact that there have been multiple rules that attack birth control, uh, there, uh, trying to make it really hard for even some of the most informed advocates to stay up to speed with everything that's been happening. Um, so really now more than ever, it's important to talk, uh, and have elected officials talking about why, uh, birth control matters.

Jennie: Yeah. I'm thinking, you know, the religious refusals part of that was, um, so expansive and so many people just didn't know kind of the full scope of that. Um, I think I talked about it on the show before. Somebody I'm really close to is actually the president of a local hospital. And I remember venting to her about, uh, when these rules were being proposed about how expensive they were, and she just did not have a good grasp on, on that. And you know, you would think that some of these people in these positions might've had a better idea, but there was just so much, uh, so many complicated parts of it that people didn't necessarily know all the details.

Jacqueline: Our partners, Planned Parenthood had over 200,000 people submit comments before, uh, the regulation could become a final and start to take effect. But even that grass number of people taking comments and sending in their thoughts to the Department of Health and Human Services, um, there's still so little that's known about it. And here's why I think we're not seeing more attention to it is because the rule has now been final and should actually its implementation date, the date at which it should start to take effect is, uh, later in January of 2019. So it's not until unfortunately I think people actually feel the results and the hardships of these regulations could where, in fact, people could be denied birth control and not know. It's because their employer has decided not to cover, uh, the insurance to covers birth control. Um, it's really unfortunate that somebody would have to go from having a no copay birth control, uh, to, uh, showing up at the pharmacy one day and then having a to pay for the first time in years. Uh, it's not until we start to hear those stories of people speaking up our people. I think gonna, um, take more, uh, attention to what all of this really means. And it's unfortunate that it has to, um, take effect at all. But I do think that they're speaking out. Sharing stories is going to be especially important. Um, and even just using social media to share why birth control has made a difference in women's lives and individuals who rely on birth control are able to, uh, continue their education and continue their employment opportunities, um, of being able to plan and space their, uh, birth of their families uh, really has contributed. I think one of the exciting moments that we're in right now is an incoming class of new women into the congress. Many are young women, many of them are young moms and um, all have their own story of how uh, being able to access reproductive health care and birth control has led them to this moment. So as bad as some of the impact of these rules can be, I do think that, um, there's a lot of power in storytelling.

Jennie: Absolutely. You know, it's so important cause I think a lot of people get to a place in their lives where they can forget how expensive birth control can be to people who can't afford it. I mean, I definitely remember a time right out of college, even with insurance my birth control was going to be like $65 a month. And I really had to think about it. And there was definitely a time where I wasn't, where I just couldn't make that choice where I just chose to not use birth control. Um, and you know, I was in the place where it was, that was an okay decision for me, but, um, not everybody can make that decision and people shouldn't have to make that decision.

Jacqueline: Yeah, absolutely. I can remember a former member of Congress, a, a woman member of Congress saying her birth control story was, uh, trying to decide whether to afford the bus fare to get her son to daycare and herself to work or to, uh, put out the money for that birth control so that she could, uh, continue to working, taking care of the son that she had and prevent, um, uh, future, uh, births until she was ready. And, um, it's one of the reasons that compelled her to come to Congress and be a member of Congress, uh, and talking about that real life impact. And it's one of the collective community successes of the affordable birth...of the Affordable Care Act when we actually had, uh, no copay, birth control pass under that law. Um, this is exactly the kind of progress the Trump/Pence administration is trying to take away. Um, not just, uh, the prescription birth control, but all 18 FDA approved forms of birth control. And we know that a long acting reversible contraception could be up to $1,200 if you use certain types of IUD. Um, and so most people are not paying that out of pocket, um, that is going to be too much of a barrier. So it's really these protections long fought for protections and the Affordable Care Act that have to be, um, continually talked about, shared and uh, why elected officials who are the incoming class of the 116 congress. We're going to have to work to protect and push back against the Trump/Pence administration. The one bright spot, I guess I would say about what everything we've been seeing, the regulations, all the things that have been coming out is that, at least for right now, uh, we haven't lost completely. And all of that progress. Um, the Affordable Care Act is still in place. And as law of the land, affordable birth control under the no k, no copay, birth control benefit does still in fact exist. Um, Medicaid has not been completely dismantled yet. We know, and, uh, talked a lot about all of the actions that they have take and we'll continue to take to go after sexual and reproductive health and rights. But, um, I believe in a lot of ways they haven't been successful because, uh, people have used their collective power and their voice, um, to speak up.

Jennie: Um, and there's just one thing you want to make sure that we're clarifying and that's the birth control part of the rule has been, is finalized and will be going into effect in January, but the more expansive kind of religious refusals part has not been finalized yet. Right?

Jacqueline: Yeah, that's right. Um, and, uh, we are awaiting a regulation to be really technical, uh, a 1557 regulation, which is a portion of the Affordable Care Act that would protect people from, uh, allowing religion to discriminate against their health care. We're still waiting, um, for the Trump administration to put that regulation through. We've only seen it proposed at this point.

Jennie: Um, I think another thing that's really worth talking about that we're seeing both on the domestic side and on the international side is censorship. Um, and trying to prevent, um, the State Department or Health and Human Services from using certain words around, um, sexual and reproductive health.

Jacqueline: Yeah. I think, um, a lot of people did not pay attention to this because of the flurry of information that was coming, but with the Centers for Disease Control, and I know also over at the State Department and information shared with us embassies around the world, we've seen attempts through, uh, internal memos at these federal agencies that would discourage the use of phrases like sexual reproductive health care, uh, trying to a eliminate a references to transgender individuals. And essentially you might stop and think what would be the purpose of circulating a memo like that? Why are they trying to, uh, really sensor the words of, uh, government employees who are working on these programs and at its core, right? This is just about further stigmatizing, discriminating against individuals and trying to create eraser, um, really and trying to erase a, again, the reality of people's lives and the idea that the Centers for Disease Control a would not be able to talk in scientific evidence based terms about sexual reproductive health care is censorship and it's also just really an attack on science. Uh, and so, uh, we at Planned Parenthood had been to bring more attention to this and um, are putting up a on our trapping trackingtrump.org is a website where we have been trying to capture all of these, uh, actions, make sure that we're sharing with our supporters and they can read on their, about all of these at the, all the, these attempts. But we also have been, uh, using supportive members of Congress, um, members of Congress who are supportive of sexual reproductive healthcare and rights, um, doing letters, uh, asking for more information and, and clear oversight and accountability of these agencies. Um, and that's going to be even really more important in 2019 as the House has, uh, taken back the, the taken back by those who are supportive of sexual reproductive health and rights. I hope this year we're going to see some, uh, oversight and investigations into, uh, how science really has been undermined by this administration.

Jennie: Yeah, that's kind of one of my pet issues. Um, I come from actually an environmental science background. Um, so science is always like one of those things that when I just see all of these attacks just on kind of basic science, it just really fires me up.

Jacqueline: Yeah. And there's, and there's so much of it happening. I mean, look at the, uh, Teen Pregnancy Prevention program. Um, this is a program that is now about eight, nine years old that has been funded to make sure that comprehensive sexuality education is available to young people. Uh, and unfortunately the Trump/Pence administration has tried to, uh, even target a program like that with a wrong science and, um, not using evidence based practices and those kinds of programs. And instead have tried to change those programs into what they are now calling sexual risk avoidance. Uh, we should not be mixed up or confused that's the same old school abstinence only until marriage, uh, kinds of, uh, agenda that we saw in previous administrations and just using a new dressed up name and again, not, uh, based in science, not being inclusive of LGBTQ and, uh, uh, young people and having, uh, really standing on the side of making sure everybody has access to full information. Um, that's another area where the courts have been really important because of the Trump/Pence administration's efforts to try to take evidence based, uh, policies away from programs like the Teen Pregnancy Prevention program, and try to change it using regulations and funding announcements. Um, we've seen courts, uh, step in and, uh, stop the Trump/Pence administration so far from being able to make those changes.

Jennie: Yeah, I um, found, so the sexual risk avoidance language is definitely pulling from like public health and like how they would talk about disease control. And, um, so that was definitely something when I was at the American Public Health Association conference and I was talking about, um, on a panel presenting about our 50 state report card we do was flagging that, you know, people really need to keep an eye on that because they are taking public health language to repackage the same terrible abstinence only and not using evidence-based, um, programs to, to uh, fight it.

Jacqueline: It's a really amazing to think about as a country, right? We've made a lot of progress in 30 years or so of uh, reducing, um, the number of young people who are facing, um, pregnancy before they choose to, increasing the number of young people who have the full range of information and ability to access services um, if they choose to be sexually active. And now, unfortunately, because of misinformation, not making policy decisions based on the evidence of where we've come, as you said using phrases that sound like they're public health but are just dressed up to mean abstinence only. Uh, it is really a sign that we could go, we could go backward, we could lose the kind of progress that has resulted in, uh, young people, uh, being, uh, more competent, more informed, uh, about their decisions for their health and bodies and wellness. And so, um, uh, we know that, again, I'm just really hopeful that this incoming congress, uh, can be a place that in the US House of Representatives at least, uh, will be a place so they can look through, uh, more oversight of the Teen Pregnancy Prevention program. But, uh, also hopefully a start to get our investments back on a track of where, uh, federal money attracts, where the evidence and where science tells us to go.

Jennie: So thinking about that abstinence only, it just makes me think kind of a theme that we keep pulling out is shame and stigma. Like trying to increase shame and stigma around sexual and reproductive health around comprehensive sex education. Yeah, that's so depressing.

Jacqueline: Yeah, I mean, I, I do think that, uh, when you peel back all the layers, the details, the regulations, all the things that happened and were released in 2018, you are so correct that this is a clear agenda by the Trump/Pence administration to, uh, put forward shame, increase stigma, um, to, uh, not talk about sexual or reproductive health care, uh, and somehow stigmatize and not normalize that, uh, the sexuality, health and education is about our daily lives for all of us. You know, I think that it really is just a sign that, um, this, uh, administration and the politicians who follow this sort of agenda need to probably get out of Washington and meet more people on the ground. We know that, uh, whether you're republican or Democrat, parents all all across the country want their young people to have access to evidence-based accurate information. Um, so know these attacks that we're seeing on evidence, on facts, whether it's, I think, you know, in journalism and health care, in the public health field, there are these key themes. And so I just kind of keep coming back to I think, uh, supporters of reproductive health care and rights and activists, uh, really have to take as much action as they can by sharing their stories of being active on social media, um, talking to elected officials, getting their communities engaged. Um, and I am really impressed that the last two years we've not seen that waiver. I mean, since the Women's March of 2017 I think we've seen increased activism and people wanting to, uh, really shine a light and put a mirror up to what's happening with this administration. So I, I have to be encouraged that that kind of activism is going to continue and the pendulum will swing the other way, I think, hopefully.

Jennie: I think so. I think that leads perfectly into, so there was a lot of bad things that happened last year, tempered by the great response that people are having a fighting back and pushing back on these policies. So looking into next year, what's, what's giving you hope? What's making you excited?

Jacqueline: I want to go back just a second to the 2018, um, wrap up. And I think we focused a lot on how much happened and it felt like it was an oncoming, uh, release of regulations and votes when, um, all of these fights we asked people to get involved in. At the end of the day, we did have some success, right? Not defunding Planned Parenthood, not the dismantling of the affordable care act, um, by pushing back against, um, regulations. And I, and I still hope those that are not yet final like the domestic gag are ones that, uh, we will see a rapid response and push back to, um, we know that this in 2018 more people stood up for victims of sexual assault and harassment, when we saw people get involved in the confirmation battle around, uh, justice Kavanaugh, a confirmation to the Supreme Court, um. That energy, the mobilization of people who were willing to, um, come out fight after fight after fight really is I think what can carry us forward. And, um, one of the things that I'm thinking, uh, that I'm really hopeful about is that, uh, you know, later this month that we'll, we'll see another, uh, Women's March all across the country. January 19th, people will be marching. And I think also they're ready to march and act, um, and not just, uh, show up on that first day, uh, but keep their communities engaged. And I know it may seem early, but I think it also means that people are going to be thinking about, uh, the next presidential election very early, probably earlier than ever before. Uh, here is, we sit in January 2019 people are ready to think about 2020. And, um, I think there's some real possibilities of making policy changes, uh, that would, uh, really impact in protect sexual and reproductive health care. Um, I think it, uh, the more light we continue to shine on all of these actions, all the work that activists and supported are doing around the country. Um, the incoming class of the 116th Congress and the House, uh, doing oversight, asking the right questions, all of that energy I think is going to fuel us to, uh, what I'm hopeful for, which is, um, 2021 being able to uh, actually roll back some of, uh, all of the mess that we've seen these last couple of years.

Jennie: Great. And I always like to end with what can people do to fight back? So thinking in the new year, um, what can people do, I know people have been doing so much already. Is there anything new they should be doing or different or just keep calling your congressperson?

Jacqueline: Yeah, I know my organizing friends feels like, oh gosh, how could I make another phone call? How could I make another phone call? So I will, I will say two things that I think people can do, one is please know that your calls do matter when you're talking to elected officials, there is someones job who it is in that office to count the number of phone calls coming in and to report that to the elected official on a daily basis. So, um, I know that it seems like every fight, every action, uh, Planned Parenthood and all of our coalition partners, it seems like when thing that we ask activists and supporters to do is to call. Um, and that's because it does make a difference. So, um, get ready to continue ringing the phone lines in 2019 and then I would say, um, most importantly is that people should get connected locally. Um, we've seen a lot of change happen at the, uh, I focused a lot on federal elections and the outcome of the midterms bringing in, um, the first pro reproductive health majority to the US House, but there's been a lot of changes at the state and local level as well. And so I would encourage for folks to get involved with Planned Parenthood Action Funds defender program. This is a Planned Parenthood defenders is a program that you can organize yourself and your friends and your community. Um, and uh, every boy, everything from fundraisers to uh, uh, local getting together to, uh, crochet together to getting together, to, um, to take actions, to do local marches, um, to do canvasing events. Um, we really have been energized by people who are organizing themselves, um, rather than any one organization. Uh, these are people who are finding likeminded folks in their communities and, um, staying connected. And I think, uh, that is really an opportunity to hear what the issues are locally, uh, what people are most concerned about on a local level. And that's where, uh, you can make sure that your call or your request to elected officials, um, touches not just your member of Congress, but really everybody at the local and state level. I think we are going to have an increased number of state battles every state legislative session. Many of are coming back into session this month. And so we're gonna really need a lot of mobility and people turned out at the state level. Everything. A lot happens in Washington, but not everything happens in Washington.

Jennie: Yeah, I think that's so important. And it's something we've seen. Um, I know I mentioned before that Population Institute does a 50 state report card on reproductive health and rights and that's where a lot of the policies are happening, particularly around access to abortion, so it's so important to stay engaged and your local and state politics.

Jacqueline: Yeah, I think that, um, these state legislative sessions that are coming up, we're going to see an increased attack on access to abortion. Uh, we know that with the US House no longer being controlled by those who are anti abortion, um, a lot of the advocacy and rhetoric that we've seen from anti-abortion organizations, what they regularly share online is that they're going to take these, the, these fights to the states. Um, Susan B. Anthony List just came out last week saying that, um, because Congress didn't defund Planned Parenthood, we'll go piece by piece state by state. Um, so they're laying out their roadmap and, uh, they need to be met in states by advocates who are ready and are to push back um, and really, um, start thinking about how to hold elected officials at the state level accountable to prevent any of those, uh, awful abortion bans from becoming law.

Jennie: Jacqueline, thank you so much for doing this.

Jacqueline: Oh, thank you. It's 2019. It's going to be great.

Jennie: For more information, including show notes from this episode and previous episodes, please visit our website reprosfightback.com. You can also find us on Facebook and Twitter at rePROs Fight Back. If you like our show, please help others find it by sharing it with your friends and subscribing, rating and reviewing us on iTunes. Thanks for listening.

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