Abortion: March 2007

March 7, 2007

CQ's Carey Addresses Stem Cell Bills, Abortion Measure, Sunset Commissions, Labor-HHS-Education Appropriations Bill

Mary Agnes Carey, associate editor of CQ HealthBeat, discusses President Bush's veto last week of legislation that would have expanded federal funding for embryonic stem cell research, a Senate bill (S 403) that would make it illegal to take minors across state lines to obtain abortions, the possible creation of "sunset" commissions to eliminate wasteful federal programs, and the Senate Appropriations Committee's approval of a $606 billion Labor-HHS-Education spending bill for fiscal year 2007 in this week's "Health on the Hill from kaisernetwork.org and CQ." According to Carey, Bush vetoed the stem cell bill because it would support "the taking of innocent human life in the hope of finding medical benefits for others." Carey also discusses a measure (S 403) that would make it a federal crime to take minors across lines to obtain an abortion to avoid state parental notification and consent laws. The bill is expected to pass, Carey says. In addition, she examines legislation sponsored by House and Senate Republicans that would create "sunset" commissions to eliminate federal programs members consider wasteful. Advocates for seniors and the disabled are concerned the legislation could overhaul or eliminate Medicare, Medicaid and Social Security, Carey writes, adding that the measure is unlikely to be approved. Finally, Carey discusses a $606 billion FY 2007 Labor-HHS-Education spending bill, which was approved last week by the Senate Appropriations Committee. The bill includes $64.2 billion for HHS and $28.5 billion for NIH, $220 million more than the amount allocated in FY 2006 and $200 million more than Bush requested. The bill also would provide $1.9 billion for community health centers, $6.1 billion for CDC and $119 million for CDC to prepare for a possible flu pandemic (Carey, "Health on the Hill from kaisernetwork.org and CQ," 7/24).

The complete audio version of "Health on the Hill," transcript and resources for further research are available online.

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Senate Begins Debate On Federal Child Interstate Abortion Notification Act

The Senate on Friday began debate on legislation (S 403) that would allow federal charges to be filed against any individual who transports minors across state lines for the purpose of evading state abortion parental notification or consent laws, the Associated Press reports (Associated Press, 7/21). The bill, sponsored by Sen. John Ensign (R-Nev.), would authorize fines or up to one year in prison for people who violate the measure. The measure includes an exception if an abortion is necessary to save the life of a pregnant minor and would allow minors to gain judicial bypass from a judge in their home states to avoid parental notification. Under the bill, doctors who perform abortions on minors from other states also could be subject to penalties. The measure states that abortion providers in states without parental consent laws would be required to attempt to notify in person or by certified mail a parent or legal guardian of any minor abortion patient who is a resident of another state (Kaiser Daily Women's Health Policy Report, 4/25/05). A similar bill (HR 748), approved by the House in April 2005, would authorize fines of up to $100,000 or up to one year in prison for people who violate the measure and also could penalize doctors who perform abortions on minors from other states (Kaiser Daily Women's Health Policy Report, 5/6/05). Senate Majority Leader Bill Frist (R-Tenn.) is "prepared" to file for a cloture motion to end debate on the measure if a deal is not reached, CQ Today reports. Senate Minority Whip Richard Durbin (D-Ill.) said if Republicans block proposed amendments, then Senate Democrats will gauge the possibility of a filibuster, CQ Today reports (Perine, CQ Today, 7/20). Democrats are expected to propose an amendment, by Sen. Dianne Feinstein (D-Calif.), that would exempt grandparents and clergy members from being prosecuted under the legislation. Ensign has said that such an amendment is unnecessary because state parental notification and consent laws allow for minors to apply for judicial bypasses, which circumvent the parental consent requirement (Perine, CQ Today, 7/21). In addition, Democrats are expected to propose an amendment that would reaffirm support for the U.S. Supreme Court's ruling in the 1973 Roe v. Wade case -- which effectively barred state abortion bans. The Senate this week is expected to approve bill, and Republican and Democratic aides have said the parties likely will reach an agreement that will prevent the need for cloture, CQ Today reports (CQ Today, 7/20). Twenty-two states have parental consent laws in place that require a parent or guardian to provide written permission before a minor can receive an abortion, and seven states require facilities that provide abortion to notify parents prior to the procedure (Ertelt, LifeNews.com, 7/21).

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Revised South Dakota Homicide Law Could Allow Abortion Providers To Be Charged With First-Degree Murder If They Violate Ban On Procedure

Dave Gerdes, an attorney for the South Dakota State Medical Association, in a recent legal memo said that, under a revised state homicide law, physicians who violate a state law (HB 1215) that bans abortion except to save the life of the pregnant woman could be charged with first-degree murder, the AP/Aberdeen American News reports. The state Legislature last year approved an amended version of the state criminal code that changed the definition of first-degree murder to include the premeditated killing of "any unborn child," the AP/News reports. "It is at least possible that a prosecutor or a court will decide that a physician performing a procedure qualifying as an abortion under the language of the new statute can be prosecuted for first-degree murder," Gerdes wrote, adding, "As a practical matter, in due course a federal court will likely restrain the effect of [the ban] until its constitutionality is litigated. But a period of doubt may exist." The ban, which has not yet taken effect, will be on the statewide ballot in November. If approved, the law would take effect and then likely would be challenged in court. State Rep. Roger Hunt (R), the ban's sponsor, said physicians who break the law would be faced with a Class 5 felony, which carries a maximum penalty of five years in prison. However, Gerdes said that the inclusion of the "any unborn child" phrase under the revised homicide law raises a "legal uncertainty" about the potential for elevated penalties. Hunt, who also is a lawyer, said the report by Gerdes was "kind of a biased, incomplete view of the subject," but he did not rule out the chance that a physician could be charged with murder in some circumstances. "I've never been a state's attorney, but I do know that when you take the life of a human being in our society, every state's attorney is going to look at all potential charges -- murder all the way down to manslaughter and aggravated assault," Hunt said. He also said first-degree murder is an offense that a state's attorney would "not tak[e] lightly." Gov. Mike Rounds (R) said his office did not consider the likelihood that the new homicide law could increase the seriousness of charges against physicians if they violate the ban. He added that state lawmakers could address the situation in future legislative sessions if the law takes effect. "Even if one Legislature did not, you would have perhaps two or three that could review it," Rounds said (AP/Aberdeen American News, 7/22).

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Senate Approves Bill That Would Criminalize Assisting Minors To Circumvent State Parental Notification Laws

The Senate on Tuesday voted 65-34 to approve a bill (S 403) that would allow federal charges to be filed against any individual who transports minors across state lines for the purpose of evading state abortion parental notification or consent laws, the Washington Post reports (Babington, Washington Post, 7/26). Under the bill, sponsored by Sen. John Ensign (R-Nev.), people who violate the measure would be subject to a fine or up to one year in prison. The measure includes an exception if an abortion is necessary to save the life of a pregnant minor (Kaiser Daily Women's Health Policy Report, 7/24). Senate leaders last week agreed to vote on a small list of amendments to the legislation before a final vote, CQ Today reports. Senators on Tuesday voted 98-0 to approve an amendment, sponsored by Ensign and Sen. Barbara Boxer (D-Calif.), that would bar a father who rapes his daughter from suing anyone who assists in her abortion, as well as bars anyone committing incest on a minor from transporting a minor to another state to obtain an abortion, according to CQ Today. Boxer said the amendment is an "improvement" on the legislation, but she added that the bill still allows parental consent rights to fathers who impregnate their daughters and does not ban the criminal prosecution of people who assist minors who became pregnant through incest (Perine/Stern, CQ Today, 7/25). According to National Right to Life Legislative Director Douglas Johnson, 26 states that have parental consent laws would be affected (Hulse, New York Times, 7/26). Minors or their parents could not be charged under the legislation (Washington Post, 7/26).

Rejected Amendments
Senators on Tuesday voted 51-48 to reject an amendment by Sen. Frank Lautenberg (D-N.J.) that would have created new grants to teach comprehensive sex education and also would have increased after-school program funding (Fagan, Washington Times, 7/26). Another amendment by Sen. Dianne Feinstein (D-Calif.) that would have exempted grandparents and clergy members from prosecution under the bill was not brought to a vote because Feinstein was absent, and Senate Republicans did not allow Boxer to offer it instead, the San Francisco Chronicle reports (Lochhead, San Francisco Chronicle, 7/26). Fourteen Democrats and 51 Republicans voted for the final measure, and 29 Democrats, independent Sen. James Jeffords (Vt.) and Republican Sens. Lincoln Chafee (R.I.), Susan Collins (Maine), Olympia Snowe (Maine) and Arlen Specter (Pa.) voted against it (Goldberg, Chicago Tribune, 7/26).

House Bill, Next Steps
The House in April 2005 voted to approve similar parental consent legislation (HR 748) that would authorize fines of up to $100,000 or up to one year in prison for people who violate the measure (Kaiser Daily Women's Health Policy Report, 7/24). The House version also requires out-of-state physicians to provide 24 hours' notice to a minor's parents or they will be subject to criminal prosecution and allows parents of minors who undergo abortion to file a lawsuit against the person who performs the procedure (New York Times, 7/26). Sen. Richard Durbin (D-Ill.) prevented Senate Majority Leader Bill Frist's (R-Tenn.) attempt to appoint members to a House-Senate conference committee to resolve differences on the measures, saying that the Senate bill had not yet been heard in a committee and that it would be too early to have discussions between the chambers, the AP/Philadelphia Inquirer reports (Kellman, AP/Philadelphia Inquirer, 7/26). The delay of a conference committee leaves the "ultimate outcome of the legislation in doubt," CQ Today reports (CQ Today, 7/25). However, Republican leaders in both chambers said they are confident the bill will be approved before Congress recesses for the November elections, the Los Angeles Times reports (Levey, Los Angeles Times, 7/26). President Bush in a statement said he supports the legislation, adding, "Transporting minors across state lines to bypass parental consent laws regarding abortion undermines state law and jeopardizes the lives of young women" (Kenen, Reuters, 7/25). The White House added that the measure would "protect the health and safety of minors" and would "protect the rights of the parents to be involved in the medical decisions of their minor daughters consistent with the widespread belief among authorities in the field that it is the parents of a pregnant minor who are best suited to provide her counsel, guidance and support" (Washington Post, 7/26).

Reaction
Supporters of the bill said it would prevent boyfriends and others from pressuring girls to have abortions, while opponents said the bill could harm girls' safety because some parents could beat their daughter if they found out she planned to undergo the procedure, the Post reports (Washington Post, 7/26). Sen. Jim DeMint (R-S.C.) said that opponents of the legislation "want to strip the overwhelming majority of good parents of their rightful role and responsibility because of the misbehavior of a few" (AP/Philadelphia Inquirer, 7/26). Specter said, "There are too many situations where teenagers have lost the ability to communicate with their parents," adding, "I believe the existing laws are working out reasonably well" (CQ Today, 7/25). Boxer said the bill passed by the Senate is unconstitutional because it lacks exceptions for when the girl's health is in jeopardy and would require state laws to apply in other states (San Francisco Chronicle, 7/26).

Broadcast Coverage
NPR's "Morning Edition" recently included several segments on the legislation:

The program on Wednesday reported on Senate passage of the bill. The segment includes comments from Boxer, Durbin, Ensign and Sen. Rick Santorum (R-Pa.) (Naylor, "Morning Edition," NPR, 7/26). The complete segment is available online in RealPlayer.

The program on Wednesday reported on how the federal measure would impact states, such as Massachusetts, that have parental notification laws that allow for judicial waivers and bordering states without parental notification laws, such as Connecticut, New York and Vermont. The segment includes comments from Marie Sturgis, executive director of Massachusetts Citizens for Life; a minor who assisted another female minor in obtaining a waiver from a judge to obtain an abortion without her parents' permission; and a clinical assistant who performs intakes at the Greater Boston Center, a Planned Parenthood League of Massachusetts clinic (Arnold, "Morning Edition," NPR, 7/26). The complete segment is available online in RealPlayer.

The program on Tuesday reported on debate over the legislation. The segment includes comments from Johnson and Nancy Keenan, president of NARAL Pro-Choice America (Rovner, "Morning Edition," NPR, 7/25). The complete segment is available online in RealPlayer.

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Amnesty International Considering Proposals To Support Contraception Access, List Abortion In Some Cases As Human Right

Amnesty International as soon as next year could decide on proposals that would support legal access to contraception and access to abortion in cases of rape or to save the life of the woman, the AP/San Diego Union-Tribune reports. The proposals arose from the group's program to curb violence against women. The group said issues such as forced marriage of young girls and illegal abortions also are being discussed. As a result of the proposals, some abortion-rights opponents and Roman Catholic officials are threatening to drop their membership and donations. Amnesty, a Nobel Peace Prize winning human-rights group with more than 1.8 million members, was founded in 1961 by a Catholic lawyer in the United Kingdom, and religious groups "have long been a pillar of the organization," according to the AP/Union-Tribune. However, Cardinal Renato Martino, head of the Pontifical Council Office for Justice and Peace, and other high-ranking Catholic officials have disparaged the abortion- and contraception-related proposals. The Society for the Protection of the Unborn Child, one of the U.K.'s largest antiabortion groups, has urged members not to support Amnesty if the proposals pass. "This is completely inconsistent with what Amnesty has been about," John-Henry Westen, board member of the Toronto-based Campaign Life Coalition, said, adding, "We consider this an attack on the rights of the unborn." According to the AP/Union-Tribune, a decision on the proposals could be reached at the group's next international meeting in Mexico in August 2007, but the group in a statement said "much depends on the outcomes" of debates among organization members around the world. The statement also says that Amnesty policy decisions "are rooted in human rights values, principles and standards" and the group "does not make policy according to the ebbs and flows of external pressure." High-ranking Amnesty officials were unavailable for comment (Murphy, AP/San Diego Union-Tribune, 7/24).

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Oregon Initiative That Would Require Abortion Parental Notification Qualifies For November Ballot

An Oregon initiative that would require physicians to notify by certified mail a parent or guardian at least 48 hours before performing an abortion on a minor ages 15 to 17 has qualified to be placed on the statewide ballot in November, the AP/OregonLive.com reports (AP/OregonLive.com, 7/25). Under the proposed notification initiative, which is sponsored by Oregon Right to Life, minors would be exempt from the measure if their life or health is at risk, and physicians who refuse to comply with the notification requirement would face civil penalties. The initiative also would allow for judicial bypass in cases of potential abuse (Kaiser Daily Women's Health Policy Report, 7/10). According to the AP/OregonLive.com, supporters on July 6 submitted to the Secretary of State's office 115,845 signatures, which qualifies the measure for the statewide ballot (AP/OregonLive.com, 7/25). ORTL needed to collect 75,630 valid signatures by July 7 (Kaiser Daily Women's Health Policy Report, 7/10).

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Kaiser Daily Women's Health Report Summarizes Editorials About Bill That Would Criminalize Assisting Minors To Circumvent Parental Notification Laws

Several editorials on Thursday were published on a bill (S 403) that would allow federal charges to be filed against any individual who transports minors across state lines for the purpose of evading state abortion parental notification or consent laws. The Senate on Tuesday voted 65-34 to approve the bill, which was sponsored by Sen. John Ensign (R-Nev.). Under the bill, people who violate the measure would be subject to a fine or up to one year in prison. The measure includes an exception if an abortion is necessary to save the life of a pregnant minor. In addition, the bill would bar a father who rapes his daughter from suing anyone who assists in her abortion, as well as bars anyone committing incest on a minor from transporting a minor to another state to obtain an abortion (Kaiser Daily Women's Health Policy Report, 7/26). Summaries appear below.

Orlando Sentinel: The Senate measure is "just election-year fodder" and is an "issue that belongs with the states," a Sentinel editorial says. "Congress has no reason -- other than political -- to be involved in this debate," the editorial adds, concluding, "The states are handling it just fine" (Orlando Sentinel, 7/27).

New York Times: The Senate bill is a "mean piece of legislation, which takes a politically popular concept and applies it to a range of cases that could include particularly desperate young women," a Times editorial says. "The underlying intent of the bill's sponsors was to score pre-election points with social conservatives ... in a way that would not alarm moderate voters who believe that parents should know if their child is pregnant and considering an abortion," the editorial says (New York Times, 7/27).

San Jose Mercury News: The Senate legislation "achieves the far right's more overriding goal," which is to do "everything possible to chip away at the constitutional right to have an abortion," a Mercury News editorial says. According to the editorial, if the Senate majority was concerned with the "best interests of girls," they would have granted exemptions for girls that are accompanied by members of the clergy or grandparents; they would have granted exemptions for victims of incest; and they would have made provisions in the bill for the children in the U.S. that do not live with either parent. "Congress has wisely not intervened to require that parents be notified when children seek treatment for such problems as mental health, drug abuse or sexually transmitted diseases," the editorial says, concluding, "The same should be true for abortion" (San Jose Mercury News, 7/27).

Republicans Criticize Some Senate Democrats Trying To Block Bill That Would Criminalize Assisting Minors To Skirt State Parental Notification Laws

Some Republicans have criticized some Senate Democrats who used a procedural move to try to block a conference committee from reconciling House and Senate bills that would allow federal charges to be filed against any individual who transports minors across state lines for the purpose of evading state abortion parental notification or consent laws, the Washington Times reports (Fagan, Washington Times, 7/28). Under the Senate version (S 403) of the bill, sponsored by Sen. John Ensign (R-Nev.), people who circumvent state parental notification or consent laws by transporting minors across state lines to undergo an abortion would be subject to a fine or up to one year in prison. The Senate measure includes an exception if an abortion is necessary to save the life of a pregnant minor. The Senate bill also would bar a father who rapes his daughter from suing anyone who assists in her abortion and would bar anyone committing incest on a minor from transporting her to another state to obtain an abortion. The House in April 2005 voted to approve similar legislation (HR 748) that would authorize fines of up to $100,000 or up to one year in prison, or both, for people who circumvent state parental notification or consent laws. The House version also requires out-of-state physicians to provide 24 hours' notice to a minor's parents or they will be subject to criminal prosecution and allows parents of minors who undergo abortion to file a lawsuit against the person who performs the procedure. Sen. Richard Durbin (D-Ill.) on Tuesday prevented Senate Majority Leader Bill Frist's (R-Tenn.) attempt to appoint members to a House-Senate conference committee to resolve differences on the measures, saying that the Senate bill had not yet been heard in a committee and that it would be too early to have discussions between the chambers (Kaiser Daily Women's Health Policy Report, 7/26).

More Details
Durbin blocked the bill from being sent to the committee because he was concerned that Senate Republicans in the conference would accept the House version of the bill, which some people consider to be more restrictive on abortion rights, according to a Durbin spokesperson, the Las Vegas Review-Journal reports (Hegstad, Las Vegas Review-Journal, 7/27). Ensign responded, "What the Democrats are doing is not fair, not right," adding, "There is not an issue that separates people more than the abortion issue. ... We finally found some common ground. For the Democrats now to step up and block this is really outrageous" (Washington Times, 7/28). Representatives of some groups that oppose abortion rights, such as National Right to Life Committee President Douglas Johnson, blame Senate Minority Leader Harry Reid (D-Nev.), who voted for the bill, for the Democrats' action. Johnson compared Reid to former Sen. Tom Daschle (D-S.D.), "who would go back home to South Dakota and tell people he was for various pieces of legislation, then would work very skillfully to prevent those pieces of legislation from going all the way through." Reid in a statement responded, "Republicans are in control of both the House and Senate. If the supporters of this legislation are concerned about delays, they should encourage [Frist] to push the House to pass the Senate-passed bill" (Las Vegas Review-Journal, 7/27). But House Republicans are adamant about having negotiations with the Senate, Kevin Madden, spokesperson for House Majority Leader John Boehner (R-Ohio), said, adding, "We don't want to pass a weaker bill" (Washington Times, 7/28). Frist, at a news conference, said that he had the 60 votes required to remove the block but that it would take several days to obtain the votes. He did not say when he would consider using the procedural move to overcome the Democrats' block (Las Vegas Review-Journal, 7/27).

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Sen. Frist Says Support Of Embryonic Stem Cell Research, Opposition To Abortion Rights Not Inconsistent

Senate Majority Leader Bill Frist (R-Tenn.), a potential 2008 presidential candidate, in an interview on Thursday said there is not an "inconsistency" between his abortion-rights opposition and his support of a bill (HR 810) that would have expanded human embryonic stem cell research funding, the Des Moines Register reports (Beaumont, Des Moines Register, 7/28). The bill, called the Stem Cell Research Enhancement Act of 2005 -- which President Bush vetoed last week -- would have allowed funding for research using stem cells derived from embryos originally created for fertility treatments and willingly donated by patients. Federal funding for embryonic stem cell research is only allowed for research using embryonic stem cell lines created on or before Aug. 9, 2001, under a policy announced by Bush on that date (Kaiser Daily Women's Health Policy Report, 7/27). Frist in a July 13 San Francisco Chronicle opinion piece wrote, "Although I am antiabortion and believe the human embryo has moral significance from the moment of conception, I will back this embryonic stem cell research package on the Senate floor," in part because "it has now become clear that [Bush's] policy will eventually hold back scientific progress" (Kaiser Daily Women's Health Policy Report, 7/13). Frist on Thursday said that until the embryonic stem cell debate, "people said you're really for science or you're for preservation of life," but that is "not right" (Des Moines Register, 7/28). "You can be pro-life and support stem cell research," Frist said, adding, "The consistency is having a pro-life (stand) and an ethical framework" for the research (Tibbetts, Quad-City Times, 7/28). He also said that Republican abortion-rights opponents could support him despite his views on embryonic stem cell research, adding that the Republican Party "has both the diversity of views -- still, a pro-life position -- and the support of science" (Des Moines Register, 7/28). The embryonic stem cell research debate "shows the breadth of the party," according to Frist (Quad-City Times, 7/28).

Newspapers Examine Stem Cell Funding, Election Implications
In related news, the Christian Science Monitor on Friday examined the election implications of Bush's veto and the embryonic stem cell issue (Feldmann, Christian Science Monitor, 7/28). The Wall Street Journal on Friday examined the current status of private and state funding for the research (Hughes, Wall Street Journal, 7/28).

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Mich. House Approves Bills Requiring Abortion Clinics To Screen For Coercion, Intimidation

The Michigan House on Wednesday voted 67-38 to approve a package of bills (HB 5879, HB 5880, HB 5881, HB 5882, HB 5883) that would require abortion clinics to determine if women seeking abortions are undergoing the procedure because they have been intimidated or coerced, the AP/Mlive.com reports. The bills also would make coercing and intimidating women into seeking an abortion illegal and would give coerced women the ability to file a civil lawsuit. State Rep. Stephen Adamini (D) introduced an amendment, which the House did not support, that would have made it illegal to coerce a women into undergoing or not undergoing an abortion. Opponents of the bills say the legislation discourages women from seeking abortions, but advocates of the measures say that the bills attempt to "crack down on domestic violence," the AP/Mlive.com reports. "It is not about abortion," state Rep. Judy Emmons (R), a sponsor of the bills, said, adding, "It is about domestic violence ... all aspects of domestic violence and how it affects women." Adamini said the approved legislation violates a woman's constitutional rights and is discriminatory. The bills now move to the state Senate for consideration (Martin, AP/Mlive.com, 7/26).

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

CQ's Carey Addresses Abortion Bill That Would Criminalize Assisting Minors To Skirt State Parental Notification Laws

Mary Agnes Carey, associate editor of CQ HealthBeat, discusses an abortion-related bill (S 403), passed last week by the Senate, that would allow federal charges to be filed against individuals who violate parental consent and notification laws in this week's "Health on the Hill from kaisernetwork.org and CQ." Carey says that Democrats objected to begin immediately a House-Senate conference that would reconcile the Senate-approved version of the bill and a similar House-approved bill (HR 748) (Carey, "Health on the Hill from kaisernetwork.org and CQ," 7/24).

The complete audio version of "Health on the Hill," transcript and resources for further research are available online.

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Religion Becoming More Apparent In Abortion-Rights Supporters' Debate, Column Says

Religious groups that support abortion rights are "increasingly active and visible," and "their emphasis on conscience and morality ... has the potential to change the terms of the abortion[-rights] debate," Brooklyn-based journalist Rebecca Tuhus-Dubrow writes in a Boston Globe column. Like religious abortion-rights opponents, the religious abortion-rights supporters use the Bible to validate their support of abortion rights, Tuhus-Dubrow writes. She adds, "Instead of rights, the [religious abortion-rights] movement tends to emphasize moral agency and conscience," stressing the "sanctity of life and the obligation to protect the vulnerable," which consists first of women and their children. The acknowledgement of a multifaceted moral view of abortion "historically" has been "taboo in the polarized abortion debate," but the religious abortion-rights movement is "not shy about acknowledging the moral complexity" of the issue, Tuhus-Dubrow writes. Some politicians -- including Sen. Hillary Rodham Clinton (D-N.Y.), who in January 2005 said that abortion "represents a sad, even tragic choice to many, many women" -- have "embraced the idea of moral complexity," according to Tuhus-Dubrow. Despite the reluctance of some abortion-rights supporters to "embrace the approach" of religious groups that support abortion rights, the "influence of religion is increasingly evident throughout the abortion-rights movement," Tuhus-Dubrow writes (Tuhus-Dubrow, Boston Globe, 7/30).

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Editorial, Opinion Pieces Respond To Bill That Would Criminalize Assisting Minors To Circumvent State Parental Notification Laws

An editorial, opinion piece and letter to the editor respond to a bill (S 403) that would allow federal charges to be filed against any individual who transports minors across state lines for the purpose of evading state abortion parental notification or consent laws. The Senate last week voted 65-34 to approve the bill, which was sponsored by Sen. John Ensign (R-Nev.). Under the bill, people who violate the measure would be subject to a fine or up to one year in prison. The measure includes an exception if an abortion is necessary to save the life of a pregnant minor. In addition, the bill would bar a father who rapes his daughter from suing anyone who assists in her abortion, as well as bars anyone committing incest on a minor from transporting a minor to another state to obtain an abortion (Kaiser Daily Women's Health Policy Report, 7/26). Summaries appear below.

Editorial

Boston Globe: If supporters of the Senate bill "truly wanted to reduce the incidence of abortion, they would focus on reducing unwanted pregnancy, but many of the same senators" who voted for the bill "defeated funding for increased pregnancy prevention grants," a Globe editorial says. "Criminalizing the act of driving minors to abortion clinics in other states won't do anything to reduce teen pregnancy, but it could drive teen abortion underground, making it unsafe, as well as illegal," the editorial says. Supporters of the bill "claim to care about traumatized girls being pressured into having abortions, but this bill would press them into lives of ... despair," the editorial says (Boston Globe, 7/29).

Opinion Piece

Judith Warner, New York Times: "[R]adical Republicans ... have cleverly linked [the Senate bill] to one of the most basic beliefs of mainstream parenting today: namely, that parents have a right to know everything about their children and to control every aspect of their lives," Warner, author of "Perfect Madness: Motherhood in the Age of Anxiety," writes in a Times opinion piece. "It is not unreasonable for parents to want to know what's going on with their kids," Warner writes, adding, "I would just suggest that parental rights have limits." She adds that to deny girls seeking abortions "access to freedom from forced pregnancy ... is to abuse them" (Warner, New York Times, 7/29).

Letter to the Editor

Carol Roye, New York Times: "[T]he senators who voted for [the Senate bill] got it wrong," Clark, professor of nursing at Hunter College Schools of the Health Professions, writes in a Times letter to the editor, adding, "If teenagers do not tell their parents" they plan to undergo the procedure, "there is usually a good reason." She concludes, if this bill is signed into law, "[w]ho will protect those teenagers who stand to be abused if they reveal the pregnancy to their parents?" (Roye, New York Times, 7/30).

CQ's Carey Addresses Health IT Legislation, Medicare Payments, Abortion Bill

Mary Agnes Carey, associate editor of CQ HealthBeat, discusses the House's passage of health information technology legislation, Medicare physician payments and an abortion-related bill passed last week by the Senate that would allow federal charges to be filed against individuals violating parental consent and notification laws in this week's "Health on the Hill from kaisernetwork.org and CQ." Carey notes that the House last week voted 270-148 to approve a bill (S 1418) that would promote use of health IT. The bill differs from one (HR 4157) the Senate approved in November 2005 on privacy, funding and other issues. In other news, lawmakers in the House and Senate have said that they want to take action this year to reverse a scheduled 5% reduction in Medicare physician payments. Carey notes that such a plan could be difficult because of the complexity of the issue, the limited amount of time left in the congressional session and funding needed to reverse the cut. CMS Administrator Mark McClellan told lawmakers that CMS would work with them to address the payment issue but said that legislators would need to implement new quality measures and other steps before putting more funds into the payments. Finally, Carey talks about a bill (S 403) approved by the Senate that would establish as a federal crime the act of taking pregnant minors across state lines to avoid parental notification and contsent laws to obtain abortions. The House has passed a similar bill (HR 748), though some Democrats objected to immediately beginning a House-Senate conference to reconcile the legislation (Carey, "Health on the Hill from kaisernetwork.org and CQ," 7/31).

The complete audio version of "Health on the Hill," transcript and resources for further research are available online.

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

March 5, 2007

FDA Chief Calls For Meeting With Barr Subsidiary, Says Age Restriction In Nonprescription Plan B Application Should Be Raised To 18

FDA and Barr Laboratories have agreed to meet to discuss the company's application for nonprescription sales of its emergency contraceptive Plan B, FDA announced in a statement Monday, adding that it hoped remaining concerns regarding the application "can be wrapped up in a matter of weeks," the Philadelphia Inquirer reports (McCullough, Philadelphia Inquirer, 8/1). FDA in May 2004 issued a "not approvable" letter in response to an application originally submitted by pharmaceutical company Women's Capital for nonprescription sales of Plan B, which can prevent pregnancy if taken up to 72 hours after sexual intercourse. Women's Capital later was purchased by Barr (Kaiser Daily Women's Health Policy Report, 5/15). The agency cited inadequate data on its use among girls younger than age 16. After FDA rejected Barr's first application, the company submitted a revised application to make the drug available only to girls and women ages 16 and older (Kaiser Daily Women's Health Policy Report, 7/23/04). After FDA rejected Barr's first application, the company submitted a revised application to make the drug available only to girls and women ages 16 and older. Former FDA Commissioner Lester Crawford in August 2005 opened a 60-day public comment period on the application, saying science supported approval of nonprescription Plan B access for women and girls ages 17 and older, but the application presented FDA "with many difficult and novel policy and regulatory issues," including enforcement of an age restriction. The comment period expired in November 2005, and the agency did not indicate when it might make a decision on the application (Kaiser Daily Women's Health Policy Report, 5/25).

Letter
A July 31 letter from acting FDA Commissioner Andrew von Eschenbach to Barr's subsidiary Duramed Pharmaceuticals says that 18 is the "appropriate age" to allow women to buy Plan B without a prescription (Alonso-Zaldivar, Los Angeles Times, 8/1). In the letter, von Eschenbach asked Barr to raise the age restriction in its application from age 16 to 18 (Rockoff, Baltimore Sun, 8/1). FDA also requested that Barr make unspecified changes to the packaging for Plan B and asked for a thorough description of Barr's plan to enforce the age restriction (Weiss, Washington Post, 8/1). Barr intends to make nonprescription Plan B available only at pharmacies -- not in gasoline stations or convenience stores -- and to require that the pills be placed behind the counter and that individuals purchasing the medication present photo identification, the New York Times reports (Saul, New York Times, 8/1). Von Eschenbach in the letter wrote that FDA wants to learn more about Barr's plan to monitor pharmacies' compliance with the age restriction and what the company plans to do "if a pharmacy fails to comply with them." Von Eschenbach added, "If after our discussions we conclude (your) program isn't sufficiently rigorous ... Plan B will remain [prescription]-only for women of all ages" (Graham, Chicago Tribune, 8/1). The letter "stopped far short" of saying FDA will approve Barr's application, but the consideration of the application is a reversal of a previous implication that the agency might not have the legal authority to approve the application with an age restriction, the Washington Post reports (Washington Post, 8/1). The letter addresses the agency's authority to approve the application and says that after reviewing a summarized and categorized contractor's report, submitted May 19, on the roughly 47,000 public comments, FDA agrees with the majority of comments that said it is not necessary to "engage in rule making" to address the age-related regulatory issues (FDA letter, 7/31). The letter requests a meeting with Barr within seven days (Rackl, Chicago Sun-Times, 8/1).

Reaction
Barr CEO Bruce Downey said he is pleased with FDA's communication but added that the proof will be in the outcome of the application. He said the company's age-restriction plan "provides adequate safeguards," adding that he still believes the drug should be available without a prescription to women and girls of all ages (Wilde Mathews, Wall Street Journal, 8/1). Barr spokesperson Carol Cox said that the company needs to meet with FDA to receive "some clarity" about what FDA officials need from the company (Rubin, USA Today, 8/1). She also said that the company had some concerns about what Barr would be required to show to be in accordance with the letter's requirements but added that Barr would be "pleased to set up a meeting as soon as possible with FDA." She said, "Overall, I think [the letter is] a positive development" (Washington Post, 8/1). HHS Secretary Mike Leavitt said the letter shows a "good-faith effort on the part of Dr. von Eschenbach to help resolve the issues surrounding Plan B" (Los Angeles Times, 8/1). In addition, the announcement has "raised hopes" among nonprescription Plan B advocates that the "unusually glacial review of Plan B might soon accelerate," according to the Post (Washington Post, 8/1).

Von Eschenbach Confirmation Hearing Begins
The Senate Committee on Health, Education, Labor and Pensions on Tuesday is scheduled to hold a confirmation hearing on the nomination of von Eschenbach to permanently head the agency (Kaiser Daily Women's Health Policy Report, 7/26). FDA spokesperson Susan Bro said the agency made the letter public "in anticipation of needing to bring before the committee ... the agency's response to the review process" of Plan B and to "resolve what has been one of the most divisive issues this agency has faced" (Carey/Crowley, CQ Today, 7/31). Bro said that von Eschenbach wanted to talk to the committee about the agency's plan for a decision on the Plan B application, adding, "This is a model for how he currently makes decisions and will continue to as the leader of this critically important public health issue" (New York Times, 8/1). She also said von Eschenbach did not want Plan B to be the focus of the hearing, adding he "believes that resolving this issue is a critical step in moving the agency's agenda forward" (USA Today, 8/1).

Murray, Rodham Clinton Continue Hold on Nomination
Sens. Patty Murray (D-Wash.) and Hillary Rodham Clinton (D-N.Y.) on Monday reiterated their plan to place a hold on von Eschenbach's nomination until FDA makes a final decision on Barr's application (USA Today, 8/1). The agency's announcement on Monday was "nothing more than another delay tactic," Murray and Rodham Clinton said in a statement, adding, "Rather than moving this process forward and doing right by the American people, the [Bush] administration is continuing to play a game of smoke and mirrors the day before Dr. von Eschenbach's Senate confirmation hearing" (Pugh, McClatchy/Charlotte Observer, 8/1). Murray and Rodham Clinton said the hold should be sufficient to block von Eschenbach's confirmation (USA Today, 8/1). However, if Bush gives von Eschenbach the job through a recess appointment, their efforts would be unsuccessful, they said (Washington Post, 8/1). The White House declined to comment on the hold (USA Today, 8/1).

Related Editorial
"If the FDA is truly ready to give Plan B its approval, then von Eschenbach surely will not mind a short delay in his confirmation while the agency and the drug maker work out the details" of the agreement, a Los Angeles Times editorial says. While FDA's announcement comes at an "awfully convenient" time, if the agency "follows through" with the approval of Plan B for nonprescription sales, then U.S. women will be the "real winners," the editorial says, concluding, "[M]aybe Monday's announcement is a sign that the FDA is less interested in acting as the judge of women's morals than as the protector of their health" (Los Angeles Times, 8/1).

Related Lawsuit
The Center for Reproductive Rights in a July 21 letter to a federal judge requested that the White House provide any letters, e-mails or records of conversations its staff exchanged with FDA in regard to Barr's application, the AP/Forbes reports (AP/Forbes, 7/28). CRR -- on behalf of the Association of Reproductive Health Professionals, the National Latina Institute for Reproductive Health and others -- filed a lawsuit against FDA in a U.S. District Court in New York, claiming the agency did not follow procedure when it denied the original nonprescription Plan B application (Kaiser Daily Women's Health Policy Report, 5/15). A hearing on the July 21 request -- which was sent to federal Magistrate Viktor Pohorelsky, who is hearing arguments in the lawsuit -- is scheduled for Thursday in New York City. CRR also is seeking to depose White House official Jay Lefkowitz, the AP/Forbes reports (AP/Forbes, 7/28). CRR attorney Bonnie Jones in May told Pohorelsky that CMS Administrator Mark McClellan, while head of FDA, had a discussion with a White House official about Plan B. A copy of McClellan's appointment calendar for April 21, 2003, a few days after Women's Capital's application submission, reads, "Conference call w/Jay Lefkowitz re: Plan B submis." Lefkowitz is the former deputy assistant to President Bush on domestic policy and currently serves as special envoy on human rights in North Korea (Kaiser Daily Women's Health Policy Report, 5/15). Todd Glass, a spokesperson for CRR, said the government has requested a continuance in the lawsuit (Washington Post, 8/1).

Broadcast Coverage
Several broadcast programs recently reported on FDA's letter regarding Plan B:

ABCNews' "World News Tonight": The segment includes comments from Downey; Murray; and Wendy Wright, president of Concerned Women for America (Stark, "World News Tonight," ABCNews, 7/31). Complete video of the segment is available online.

APM's "Marketplace Morning Report": The segment includes comments from Bridget Behling, managing editor of the Tan Sheet, a publication covering nonprescription pharmaceutical and nutritional products; and Brian Laegeler, an analyst for Morningstar (Milne-Tyte, "Marketplace Morning Report," APM, 8/1). The complete segment will be available online in RealPlayer a few hours after the broadcast.

NBC's "Nightly News": The segment includes comments from Rodham Clinton; Vanessa Cullins, vice president for medical affairs at Planned Parenthood Federation of America; and Wright (Costello, "Nightly News," NBC, 7/31). The complete segment is available online in Windows Media. In addition, video of a related MSNBC segment is available online in Windows Media.

NPR's "All Things Considered": The segment includes comments from Bro and Kirsten Moore, president of the Reproductive Health Technologies Project (Rovner, "All Things Considered," NPR, 7/31). The complete segment is available online in RealPlayer.

NPR's "Morning Edition": The segment includes comments from Bro and Murray (Rovner, "Morning Edition," NPR, 8/1). The complete segment is available online in RealPlayer.

Former Oglala Sioux Tribal President To Challenge Impeachment Over Proposed Abortion Clinic Donations Allegation

Former Oglala Sioux Tribal President Cecelia Fire Thunder on Friday said she plans to challenge her impeachment by the Tribal Council for allegedly soliciting donations on behalf of the tribe for a proposed abortion clinic without the council's approval next week in the tribe's Supreme Court, the Rapid City Journal reports (Steen, Rapid City Journal, 7/28). Fire Thunder in March in response to the approval of the South Dakota law (HB 1215) that bans abortion except to save a woman's life said, "I will personally establish a Planned Parenthood clinic on my own land, which is within the boundaries of the Pine Ridge Reservation where the state of South Dakota has absolutely no jurisdiction." However, Fire Thunder in June said she had not intended to open a clinic that would perform the procedure but rather one that would provide family planning information, emergency contraception and other contraceptives. The tribal council last month voted 9-5 to replace Fire Thunder for allegedly soliciting donations without the council's approval for the proposed clinic. Tribal Judge Lisa Adams reinstated Fire Thunder last month, arguing that her removal violated tribal procedure. However, she retracted her decision after receiving a motion that said she did not have the authority to issue an injunction against the tribe or a tribal official and later recused herself from the case (Kaiser Daily Women's Health Policy Report, 7/20). Fire Thunder said she has not received due process in the lower court and is appealing the decision on procedural grounds. When Adams recused herself from Fire Thunder's case, proceedings were put on hold to allow the tribal council to appoint a new judge. Tribal council attorney Tom Blanco on Friday filed a motion to dismiss Fire Thunder's case (Rapid City Journal, 7/28).

Tribe's View of Abortion
Tribe members officially have not been surveyed, but many said they support exceptions to an abortion ban in the case of rape, incest or to protect the health of the pregnant woman, the Chicago Tribune reports. According to Department of Justice statistics, American Indian women are three times more likely to be sexually assaulted than white women, and rape and incest are more common on reservations than in the rest of the U.S. Regardless of people's views on abortion, "people on both sides seem to agree" that "abortion is women's business, not suitable for men to be discussing in the chambers of the tribal council or anywhere else," according to the Tribune. The Oglala Tribal Council has passed an ordinance that prohibits abortion procedures on the reservation, the Tribune reports (Peres, Chicago Tribune, 7/30).

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Kaiser Daily Women's Health Policy Report Highlights Women's Health Policy Issues Related To 2006 Elections

The following highlights recent election-related news on women's health issues.

California: State Treasurer and gubernatorial candidate Phil Angelides (D) on Friday in San Francisco made his first public statements in opposition to Proposition 85, a statewide ballot measure that would require doctors to notify parents or guardians before performing an abortion on a minor, the Sacramento Bee reports (Hecht, Sacramento Bee, 7/29). The measure would require unmarried girls younger than age 18 to inform a parent or legal guardian of their intention to have an abortion 48 hours before undergoing the procedure. The initiative is similar to Proposition 73, which failed in November 2005, but it eliminates language that defines abortion as resulting in the "death of an unborn child, conceived but not yet born." In addition, Proposition 85 does not include a provision in Proposition 73 that would have mandated reporting on how many judicial waivers a judge has approved (Kaiser Daily Women's Health Policy Report, 5/23). "There is now an effort by antichoice extremists to roll back the clock to a much darker day," Angelides said, adding, "The fact is, voters of California rejected a similar measure (last year) and said it was wrong for antichoice extremists and Gov. Arnold Schwarzenegger (R) to jeopardize teen safety." Schwarzenegger supported Proposition 73 last year but has not publicly stated a position on Proposition 85, according to the Bee. "The governor's position on parental notification has not changed," Katie Levinson, Schwarzenegger campaign spokesperson, said, adding, "The people spoke last year" in defeating Proposition 73 (Sacramento Bee, 7/29).

Michigan: Abortion-related issues in the 7th District are a key issue in the Republican primary, which is between Rep. Joe Schwarz and Tim Walberg, the Jackson Citizen Patriot reports. Schwarz, a physician and an abortion-rights supporter, has said that the "decision [to have an abortion] should not be made by a bunch of middle-aged, gray-haired men. ... It should be made by the woman herself." Walberg, who has called opposition to abortion rights a "moral absolute" and has said abortion should be illegal with no exceptions, in January was endorsed by Right to Life of Michigan, the state's largest abortion-rights opposition group. "The only exception I would give in very, very rare cases ... is for the life of the mother," Walberg said, adding, "Not the health of the mother. The health of the mother is fraught with too many vagaries and potential abuses" (Jackson Citizen Patriot, 7/30).

Tennessee: Candidates seeking the Republican nomination in the U.S. Senate race in Tennessee should focus their campaigns less on abortion-related issues and more on other state issues in advance of the party's primary Thursday, Lloyd Daugherty, chair of the state's Conservative Union, said Saturday at the group's annual Reagan Day Dinner in Knoxville, the AP/Knoxville News reports. "Some folks assume that all conservatives care about is abortion and gay marriage," he said, adding that efforts to ban abortion are "vitally important, but there is so much more to conservatism." The three leading candidates for the Republican nomination are Reps. Ed Bryant and Van Hilleary and former Chattanooga Mayor Bob Corker. Bryant and Hilleary have said they would support a state abortion ban that allows exceptions only to save the life of the woman, and Corker has said he would support a ban that allows exceptions for rape and incest and to save the pregnant woman's life. The winner of Thursday's primary likely will face Rep. Harold Ford in November (AP/Knoxville News, 7/31).

Senate Democrats Question New FDA Requirements For Nonprescription Plan B Application At Von Eschenbach Confirmation Hearing

Democrats on the Senate Health, Education, Labor and Pensions Committee on Tuesday during a confirmation hearing on acting FDA Commissioner Andrew von Eschenbach's nomination to permanently head the agency questioned him regarding the FDA's review of an application requesting approval for nonprescription sales of Barr Laboratories' emergency contraceptive Plan B, the Washington Post reports (Weiss, Washington Post, 8/2). FDA in May 2004 issued a "not approvable" letter in response to an application originally submitted by pharmaceutical company Women's Capital for nonprescription sales of Plan B, which can prevent pregnancy if taken up to 72 hours after sexual intercourse. Barr purchased Women's Capital during consideration of the application. FDA in the "not approvable" letter cited inadequate data on its use among girls younger than age 16, and Barr subsequently submitted a revised application to make the drug available only to girls and women ages 16 and older. Former FDA Commissioner Lester Crawford in August 2005 opened a 60-day public comment period on the application, saying science supported approval of nonprescription Plan B access for women and girls ages 17 and older, but the application presented FDA "with many difficult and novel policy and regulatory issues," including how to enforce an age restriction. In a July 31 letter to Barr subsidiary Duramed Research, von Eschenbach wrote that 18 is the "appropriate age" to allow women to buy Plan B without a prescription and asked Barr to raise the age restriction in its application from 16 to 18. The letter also requested that Barr meet with FDA within seven days, make unspecified changes to the packaging for Plan B and provide a thorough description of the company's plan to enforce the age restriction. The letter says, "If after our discussions we conclude (your) program isn't sufficiently rigorous ... Plan B will remain [prescription]-only for women of all ages" (Kaiser Daily Women's Health Policy Report, 8/1). Barr spokesperson Carol Cox on Tuesday said no decision had been made between FDA and the company on when the two would meet to discuss the application. FDA spokesperson Susan Bro on Tuesday said the agency plans to meet with Barr Monday (Bridges, AP/Forbes, 8/1).

Plan B Comments at Hearing
Von Eschenbach at the hearing said he would be open to approving nonprescription Plan B sales for women ages 18 and older, adding that approval could happen within weeks, the New York Times reports (Zernike, New York Times, 8/2). However, Democrats on the panel "hammered" the nominee on the "timing and substance" of the letter he sent to Duramed, the AP/Forbes reports (AP/Forbes, 8/1). "We all know what's going on here," Sen. Tom Harkin (D-Iowa) said, adding, "It's the disregard of science for ideological concerns" (New York Times, 8/2). Von Eschenbach said that he decided to consider the application based "not on a political ideology but on a medical ideology." If the letter "leads to a swift and clear decision, I applaud it," Sen. Edward Kennedy (D-Mass.), the ranking Democrat on the committee said, adding, "[B]ut we must make certain that the [Bush] administration does not use it as yet another delaying tactic" (AP/Forbes, 8/1). Von Eschenbach said, "No one told me what I should or could do. No one told me what decision I must or must not make. [The letter] was my decision" (Rockoff/Beasley, Baltimore Sun, 8/2). He added that he is committed to "sound science" and candidness.

Age Limit, Enforcement Requirements Questioned
Sen. Jack Reed (D-R.I.) questioned why von Eschenbach requested a new age restriction for Barr's application. "Is there new data?" Reed asked, adding, "New analysis? Or have you just decided you don't like the conclusion of your predecessor?" (Washington Post, 8/2). Von Eschenbach said, "It's a cut[-off] point, and you have to have some cut[-off] point" (Alonso-Zaldivar, Los Angeles Times, 8/2). He added that the age 18 limit offers a "greater safeguard in protecting and promoting the health" of young women (Pugh, McClatchy/Miami Herald, 8/1). Von Eschenbach also said that he decided on the age limit in part because tobacco products have the same age restriction. Reed said the limit "seems ... arbitrary" (Los Angeles Times, 8/2). Sen. Hillary Rodham Clinton (D-N.Y.), who with Sen. Patty Murray (D-Wash.) has placed a hold on von Eschenbach's nomination until FDA renders a decision on Plan B, questioned the requirement that Barr assure pharmacies are following the age restriction. She compared the condition to requiring that alcoholic beverage distillers ensure bars do not serve underage customers.

Outlook for Nomination
According to the Post, Republicans on the committee "generally sidestepped the Plan B fight," and all members on the panel "praised von Eschenbach's resume." Von Eschenbach served as director of the National Cancer Institute for four years and had a long career at the University of Texas MD Anderson Cancer Center. Some senators criticized what they say is the politicization of FDA, citing a survey released last month from the Union of Concerned Scientists (Washington Post, 8/2). The anonymous survey -- in which 997 of 5,918 FDA scientists responded -- finds that about one in six FDA scientists who participated in the survey said they have felt pressure to change the results of their work for nonscientific reasons (Kaiser Daily Health Policy Report, 7/21). Sen. Barbara Mikulski (D-Md.) said the next FDA commission needs to improve on oversight of drug safety and low spirits at the agency (Baltimore Sun, 8/2). Von Eschenbach said he opposed proposed legislation to create an independent center for drug safety within FDA but said he would emphasize drug safety. He added that he would set up means to usefully deal with scientific disagreements (Cohen, Newark Star-Ledger, 8/2). HELP Committee Chair Mike Enzi (R-Wyo.) said he intended to vote on von Eschenbach's nomination after the Senate's August recess. "The question is not whether to confirm him. The question is whether to confirm him before Plan B is approved," Enzi said, adding, "So it's not a question of qualifications" (Baltimore Sun, 8/2). Murray said, "There are a lot of rumors about a recess appointment" for von Eschenbach to head the agency (Anderson, Dow Jones Newswires, 8/1). Rodham Clinton asked if von Eschenbach would accept a recess appointment from President Bush, to which he replied, "I want to look forward to the Senate's confirmation of me as your choice to be commissioner of the FDA" (Crowley, CQ Today, 8/1). Enzi said no one in the Bush administration had discussed a recess appointment with him (Dow Jones Newswires, 8/1).

Related Editorials

Boston Globe: Because Plan B prevents pregnancy, it "should be available without a prescription to women of all ages, [b]ut even sales to older women would represent progress," a Globe editorial says. Until nonprescription sales of Plan B to women ages 18 and older is approved, "senators should keep von Eschenbach's confirmation on hold," the editorial concludes (Boston Globe, 8/2).

New York Times: "[S]keptical Democratic senators are right to threaten to block a confirmation vote" on von Eschenbach until the agency makes a decision on nonprescription sales of Plan B, a Times editorial says. Although a hold on von Eschenbach's confirmation could be circumvented with a recess appointment by President Bush, if von Eschenbach wants to be the "Senate's choice, not just the president's, he would be wise to ask Mr. Bush to let the process move forward," the editorial concludes (New York Times, 8/2).

USA Today: While FDA's "proposed compromise" to consider allowing nonprescription access of Plan B to women ages 18 and older is an "important step forward," it continues to "fal[l] short on science and sensible policy" because it would not help prevent unintended pregnancy and abortion among girls under age 18, a USA Today editorial says. In addition, FDA "warned Barr ... that unless it provides details on how the age restriction would be rigorously enforced at pharmacies," the pill will remain available only by prescription, the editorial says, concluding that this "[s]ounds like a potential excuse to reject Plan B -- after von Eschenbach is confirmed" (USA Today, 8/2).

NPR's "Morning Edition" on Wednesday reported on von Eschenbach's hearing. The segment includes comments from Harkin, Mikulski and Rodham Clinton and von Eschenbach (Rovner, "Morning Edition," NPR, 8/2). The complete segment is available online in RealPlayer. In addition, expanded NPR coverage -- including information on how Plan B works -- is available online.

Nine Washington State Women File Complaints About Lack of Access to Plan B
In related news, nine women in Washington state on Monday filed complaints with the state Board of Pharmacy alleging that four pharmacies failed to carry or stock EC despite a state regulation that requires them to fill such prescriptions, the AP/Seattle Post-Intelligencer reports. The women said they were unable to receive 17 prescriptions for EC at four pharmacies in June and July. According to Steven Saxe, executive director of the state pharmacy board, a three-member panel of the board has 21 days to decide whether to take further action on the complaints or to dismiss them. If action is taken, investigators will have 170 days to issue recommendations for review, after which a panel of three board members will issue formal charges and seek fines or other penalties, the AP/Post-Intelligencer reports (AP/Seattle Post-Intelligencer, 8/1).

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Grand Jury Investigating Death Of Woman Who Underwent Abortion At Kansas Clinic, Issues No Indictments

A Sedgwick County, Kan., grand jury investigating the death of a woman who died three days after undergoing an abortion at the Women's Health Care Services clinic in Wichita, Kan., has been dismissed without issuing an indictment, county District Attorney Nola Foulston said in a statement issued Monday, the Wichita Eagle reports (Sylvester, Wichita Eagle, 7/31). Christin Gilbert, a 19-year-old Texas resident with Down syndrome who was 28 weeks pregnant, died on Jan. 13, 2005, after undergoing an abortion at the clinic, which is owned by physician George Tiller. The Kansas State Board of Healing Arts, which regulates physicians, in December 2005 cleared Tiller and his staff of misconduct in Gilbert's death. However, Kansas law allows a grand jury to be formed within 60 days of a petition filed with a state district court if the petition has at least 100 more signatures than 2% of the number of people in the county who voted in the most recent gubernatorial election. Sedgwick County Election Office officials in April delivered a certified petition to Richard Ballinger, chief judge of Kansas's 18th judicial district, to convene a grand jury in Gilbert's case. The petition alleges the clinic committed violations, including involuntary manslaughter, mistreatment of a dependent adult, failure to report abuse of children and violation of abortion-related statutes (Kaiser Daily Women's Health Policy Report, 5/5). The grand jury in May began hearing testimony in the case. The antiabortion group Operation Rescue, which gathered signatures for the petition, in a statement expressed discontent with the grand jury's investigation (Wichita Eagle, 7/31).

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Majority Of South Dakotans Against State Abortion Ban, Poll Says

The majority of South Dakotans disapprove of a state law (HB 1215) that bans abortion except to save a woman's life, according to a KELO-TV/Sioux Falls Argus Leader poll released Monday, the AP/Washington Post reports (AP/Washington Post, 7/31). The ban, which has not yet taken effect, will be on the statewide ballot in November. If approved, the law would take effect and then likely would be challenged in court (Kaiser Daily Women's Health Policy Report, 7/25). The poll, which was conducted by Mason-Dixon Polling and Research, surveyed 800 registered voters from July 24 through July 26, finding that 47% said they disapprove of the law, compared with 39% who approve of the measure and 14% who are undecided. The poll also finds that all of the people surveyed said they likely will vote in the election in November. In addition, the poll finds that if the measure were to allow for exceptions in cases of rape and incest, 59% of people would have supported it, compared with 29% who would have opposed it and 12% who would have been undecided. The margin of error in the poll was plus or minus 3.5 percentage points. Brad Coker, managing director of Mason-Dixon, told the Sioux Falls Argus Leader, "It looks like that there's no exception made for rape and incest seems to be the factor that could sink this." He added, "That's the hook the opponents [of the measure] can really build their arguments on" (AP/Yankton Press & Dakotan, 8/1).

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Editorials, Opinion Piece Respond To Bill That Would Criminalize Assisting Minors To Circumvent State Parental Notification Laws

Some editorials and an opinion piece respond to a bill (S 403) that would allow federal charges to be filed against any individual who transports minors across state lines for the purpose of evading state abortion parental notification or consent laws. The Senate last week voted 65-34 to approve the bill, which was sponsored by Sen. John Ensign (R-Nev.). Under the bill, people who violate the measure would be subject to a fine or up to one year in prison. The measure includes an exception if an abortion is necessary to save the life of a pregnant minor. In addition, the bill would bar a father who rapes his daughter from suing anyone who assists in her abortion, as well as bars anyone committing incest on a minor from transporting her to another state to obtain an abortion. The House in April 2005 voted to approve similar legislation (HR 748) that would authorize fines of up to $100,000 or up to one year in prison, or both, for people who circumvent state parental notification or consent laws. The House version also requires out-of-state physicians to provide 24 hours' notice to a minor's parents or they will be subject to criminal prosecution and allows parents of minors who undergo abortion to file a lawsuit against the person who performs the procedure. Sen. Richard Durbin (D-Ill.) on Tuesday prevented Senate Majority Leader Bill Frist's (R-Tenn.) attempt to appoint members to a House-Senate conference committee to resolve differences on the measures, saying that the Senate bill had not yet been heard in a committee and that it would be too early to have discussions between the chambers (Kaiser Daily Women's Health Policy Report, 7/28). Summaries appear below.

Editorials

Denver Post: The Senate bill is "nothing more than an election-year gambit by social conservatives who have run out of ways to encroach on abortion rights," and it might be a way for Republican legislators, who voted in favor of expanding federal funding for human embryonic stem cell research, "to appease antiabortion voters ahead of the elections," a Post editorial says. The editorial says, "Congress' focus would be better placed" on sex education, counseling, and increasing access to contraception and emergency contraception, "so girls don't have unwanted pregnancies in the first place" (Denver Post, 7/28).

Hartford Courant: If the Senate and House versions of the bill are reconciled, the "resulting law could have the opposite of the intended effect" because it "could force distraught girls to seek underground alternatives to legal abortion, to run away or take other desperate measures," a Courant editorial says. "This bill is a manufactured attempt to chip away at abortion rights," but "[a]ll it does is make a difficult situation even harder for girls who may have legitimate reasons for keeping their plight from their parents," the editorial adds (Hartford Courant, 8/2).

Minneapolis Star Tribune: The Senate measure would be "bad law" because it is "wildly fanciful" and "more likely to inflict harm" than help girls and parents, a Star Tribune editorial says. "The idea [of the law] seems sensible enough," but "[t]here's no reason to think such a law is necessary," the editorial says, adding that most girls inform at least one parent before undergoing the procedure. "But those who don't generally have good reason to keep quiet" their decision, such as being an incest survivor or having experienced parental abuse, the Star Tribune says, adding, "Surely teens caught in such circumstances deserve society's compassion." The editorial concludes, "Does Congress really think it's right to hound these lonely girls and those willing to help them? It must -- for that's really all this show-boating election-year bill would do" (Minneapolis Star Tribune, 7/31).

Tennessean: "The saddest aspect" of the Senate version of the bill is that a "meaningful option" to fund comprehensive sex education programs, offered as an amendment by Sen. Frank Lautenberg (D-N.J.), was rejected 51-48, a Tennessean editorial says. "When members of Congress get serious about trying to prevent teen pregnancies, they'll give citizens on both sides of the abortion issue some sorely needed middle ground," the editorial concludes (Tennessean, 8/2).

Washington Times: The Democrats' "obstructio[n]" of the Senate bill "has very little to do with any legal or moral arguments, and everything to do with carrying out the orders of the abortion lobby," a Times editorial says. "In a devious ploy," Senate Minority Leader Harry Reid (D-Nev.) last week voted for the bill and then "gave ... [Sen. Richard] Durbin (D-Ill.) the nod" to block it, "[w]hich is all pretty much par for the course with the abortion lobby." The editorial says that abortion-rights supporters "rarely se[e] a restriction on abortion for minors [they do not] theoretically support, if not for this, that and the other thing," concluding, "And so prevails the status quo, in which parents have less control over their child's abortion decision than the high school boyfriend or the sexual predator" (Washington Times, 8/1).

Opinion Piece

Jonathan Imbody, Washington Times: "Polls show that four of five Americans support a law requiring that at least one parent be told before a girl under 16 years of age could have an abortion," so it is "amazing" that any U.S. senator would "persist in political plots" to block the legislation from becoming law, Imbody, senior policy analyst for the Christian Medical and Dental Associations, writes in a Times letter to the editor. "If the cabal of pro-abortion senators led by Durbin persists in maneuvers to kill" the measure, then "perhaps it's time to transport them across state lines -- and let them hear from their own constituents why parents have a right to help guide their daughters' futures," Imbody concludes (Imbody, Washington Times, 7/28).