Author: Laurel Utterback

  • The “Let Pregnancy Centers Serve Act” of 2024: Key Insights and Implications

    The “Let Pregnancy Centers Serve Act” of 2024: Key Insights and Implications

    What are Crisis Pregnancy Centers?

    Crisis pregnancy centers (CPCs) are nonprofit, community-based organizations that aim to ensure pregnant people carry their pregnancy to term. CPCs provide services, including pregnancy tests, ultrasounds, baby formula, and diapers to achieve their mission. While they have operated in the U.S. for decades, CPCs have become more prominent in the public eye in light of the Supreme Court’s Dobbs v. Jackson decision that overturned the national right to abortion. Contention has emerged concerning whether CPCs should continue to receive federal funding and qualify as eligible healthcare centers for patients using federal healthcare assistance programs. 

    Introduction to the Let Pregnancy Centers Serve Act of 2024

    The Let Pregnancy Centers Serve Act of 2024 was introduced to the Senate Committee on Finance by Senator Cindy Hyde-Smith [R-MS] on January 18, 2024, and is currently in the introduction stage. The Act contains two central provisions:

    1. Maintaining TANF Eligibility: Temporary Assistance for Needy Families, or TANF, is a government program that provides financial assistance to pregnant people and families for the purpose of accessing food, housing, healthcare, and other necessities. States have autonomy in implementing TANF, including determining the type and amount of assistance payments, and the services that can be obtained with TANF funds. The Act would ensure that people who receive TANF can use their benefits to pay for CPC services, and that CPCs can continue to receive TANF-delegated funding from the federal government.
    2. Renewing federal funding: The Act would prevent the federal government from denying CPCs funding via grants, on the basis that doing so merits federal discrimination against grantees. 

    Arguments in Support of the Let Pregnancy Centers Serve Act of 2024

    Enhanced Access to Pregnancy Services

    Proponents of the Act argue that PCPs should be praised for the broad range of goods and services they provide at little to no cost, such as baby clothes and formula. Early pregnancy confirmation is cheaper and more accessible at a CPC than at an abortion clinic, which supporters argue increases accessibility. They cite a study that showed that patients without health insurance were significantly more likely to visit a CPC than not to visit a CPC during their pregnancy. Additionally, proponents believe that the educational programs provided by some centers, such as parenting classes and prenatal care, help equip new and expecting parents with necessary knowledge and skills. In addition, some CPCs offer different types of emotional and psychological support. Advocates of the Act believe that the counseling services provided by some centers can help individuals and families navigate the pregnancy experience and its complexities. 

    Protection from Federal Discrimination

    One of the primary objectives of the Act is to ensure that CPCs continue to receive TANF funding. The bill aims to prevent the Biden administration’s proposed rule that would reduce or cut TANF funding to CPCs. Proponents argue that these centers play a crucial role in providing support to pregnant women, and that losing TANF funding eligibility could significantly impact their ability to offer essential services. Advocates of the bill argue that protection against federal discrimination is crucial for maintaining the viability of CPCs and ensuring they can continue to provide their service without undue interference. Advocates emphasize that CPCs have been allowed to receive federal funding since 1996, and that reversing this practice signals federal discrimination on a national scale. Proponents also argue that states should have the flexibility and power to direct funds to organizations that align with their values and priorities, and that the federal government would infringe upon state’s rights by prohibiting funding to CPCs nationally. 

    Arguments Against the Let Pregnancy Centers Serve Act of 2024

    Misleading Patients 

    Opponents of the Act argue that CPCs provide misleading or incomplete information about reproduction with the goal of preventing patients from seeking abortion, which can impact patients’ ability to make informed decisions about their health. Most crisis pregnancy centers have a religious affiliation and are not medically licensed, and thus fall outside the scope of consumer protection regulations that are designed to protect patients. Opponents argue that CPCs purposefully and unethically market themselves as health clinics, which has led to the development of websites like ExposeFakeClinics.com and The Anti-Abortion Pregnancy Center Database to warn patients about CPCs in their area. 

    Critics also claim that many ethical concerns that arise when the government provides TANF funding to organizations that are unqualified to provide medical advice. In particular, critics argue that CPCs’ main goal is to discourage or delay women from seeking abortion services, and that providing them with TANF funding could lead patients to perceive them as legitimate and objective healthcare providers. Delays in medical care, whether it be prenatal checkups or appointments about different options, can lead to more complex and costly procedures later on, and potentially put pregnant people’s lives at risk. Critics believe that by prioritizing funding for un-licensed pregnancy centers, the government risks misleading pregnant people into seeking services at centers with no medical credentials and thus neglecting their healthcare needs.

    Misuse of Federal Funds

    Additionally, opponents of the Act are concerned that CPCs lack the oversight and accountability required of other TANF-eligible medical facilities, which could increase the risk of mismanaged or ineffectively-used federal funds. While states must spend TANF funding on programs that achieve one of four TANF purposes, some argue that CPCs are deceptive and lack patient-centered care. Critics of the Act believe that TANF dollars could be used in more efficient ways than funding CPCs, such as promoting job preparation and work. They believe that funding CPCs risks diminishing government funds that could be used to fund prenatal care, contraceptive counseling, and more comprehensive maternal health services. Many believe that allowing TANF funds to support CPCs could weaken the overall monetary support network for reproductive health in the nation. 

    Conclusion

    The Let Pregnancy Centers Serve Act of 2024 aims to protect crisis pregnancy centers by allowing states to allocate TANF and other federal grant funds to these centers without federal interference. Supporters argue that CPCs offer vital services that deserve protection and uphold states’ rights to manage their grant distributions. Conversely, opponents express ethical concerns about funding centers that lack medical qualifications, licensure, and oversight. Critics warn that the Act could misallocate federal funds, diverting resources from licensed maternal and contraceptive care programs to less regulated centers. The legislation’s outcome will significantly impact pregnant individuals nationwide.

  • Understanding the Reproductive Freedom for All Act

    Understanding the Reproductive Freedom for All Act

    Background on Reproductive Freedom 

    The history of reproductive rights in the United States has been shaped by legal debates, societal perception, and ongoing conversations about autonomy and morality. Roe v. Wade, a landmark 1973 Supreme Court decision, legalized abortion nationwide by establishing a constitutional right to privacy in pregnancy decisions. In 2022, the Supreme Court heard Dobbs v. Jackson Women’s Health Organization, a case centered on a Mississippi law banning most abortions after 15 weeks of pregnancy. It gained widespread attention as the Court reconsidered the scope of abortion rights. Ultimately, the Supreme Court upheld Mississippi’s law, which weakened the precedent set by Roe v. Wade. This decision has allowed many states to overturn formerly protected reproductive healthcare services, creating variation in what is legally protected and accessible across the United States.

    Introduction to the Reproductive Freedom for All Act

    The Reproductive Freedom for All Act originated to protect reproductive rights by ensuring that all individuals, regardless of geographic location have access to comprehensive reproductive health services. The bill can be broken down into four parts:

    1. Contraceptive Access: States cannot prohibit individuals from accessing or using contraceptives or contraceptive care.
    2. Undue Burden: States cannot impose undue burdens or excessive obstacles on a woman’s decision to have an abortion before fetal viability.
    3. Regulation Post-Viability: After fetal viability, states can regulate abortion. However, an exception will be made if a health care practitioner deems that an abortion is necessary to protect the health or life of the mother.
    4. Safety Regulations: States can create reasonable regulations that promote the health and safety of a woman seeking to terminate a pregnancy, as long as these rules are not undue burdens.  

    Arguments in Support of the Reproductive Freedom for All Act

    Proponents of the bill argue that undue burdens on women limit reproductive freedom and autonomy. Supporters of sex equality “observe that abortion restrictions deprive women of control over the timing of motherhood and so predictably exacerbate the inequalities in educational, economic, and political life engendered by childbearing and childrearing.” Targeted Restrictions of Abortion Providers, sometimes referred to as TRAP laws, create requirements for abortion providers that many believe are designed more to limit access to reproductive health services rather than to genuinely improve patient safety. One example of a TRAP law is the requirement that abortion providers comply with ambulatory surgical center building requirements. Rebuilding clinics to meet these requirements is prohibitively expensive, and, many believe, does not improve health outcomes for patients.

    The definition of undue burden remains open to interpretation, and proponents of the Act argue that these burdens are not based on science and cause more strain on overall health and freedom. The aim of this section of the legislation is to remove unnecessary barriers or obligations that inhibit the right to access reproductive care.

    Supporters of the Act argue that without federal protections, states will criminalize abortions, affecting not only women seeking to terminate unintended pregnancies but also a diverse range of patients needing medical care for various reasons. Additionally, proponents argue that restricting access to abortion leads to higher rates of unsafe abortion procedures. According to a 2018 study by the Guttmacher Institute, countries with the least restrictive abortion laws had a 1% rate of unsafe abortions, while countries with the most restrictive laws had a 31% rate. Advocates of the Act believe that regardless of the legal status of reproductive services, people will continue to seek out these services, even if it means that birth control or abortions are provided in an unsafe way. Unsafe reproductive services are considered preventable causes for maternal death and physical health risks, and are included in the World Health Organization’s list of essential health care services

    While some believe that abortion access should be legislated at the state level, others argue that restrictions in some states impact access in other states because people travel across state lines to require healthcare. For example, if New Hampshire bans the procedure but Vermont does not, people are likely to travel from New Hampshire to Vermont, increasing wait times and overwhelming clinic capacities in Vermont. For this reason, many argue that federal protection is required because restrictions in some states affect recipients of abortion services in others. 

    Inconsistent laws surrounding reproductive freedom and abortion can place an undue burden on healthcare providers who offer these services. Following the Dobbs v. Jackson Women’s Health Organization decision, states with total abortion bans required clinics to stop abortion procedures. Between 2020 and 2023, the overall number of abortions increased by 11%, and 17% were performed on patients who traveled from out of state to access services. Healthcare providers are now required to navigate evolving legal and medical circumstances and make decisions under uncertain conditions,  increasing their liability

    Restrictions on reproductive services affect providers in several ways. Staffing sustainability, changes in organization structure, increased workload for certain practitioners, and financial costs all create an increased burden on certain providers. Some argue that restrictions on reproductive freedom will ultimately create systemic inefficiencies that increase waiting times for all patients and increase workload for staff.

    Arguments Against the Reproductive Freedom for All Act

    Opponents often have religious or moral objections to the nuanced nature of reproductive ethics. Some argue that there are various key features that indicate a fetus is a living being:

    • Distinct: “has a DNA and body distinct from parents.”
    • Living: “grows by reproducing cells… turns nutrients into energy through metabolism… and can respond to stimuli.”
    • Human: “has a human genetic signature.”
    • Organism: “is an organism (rather than a mere organ or tissue) [which is] an individual whose parts work together for the good of the whole.”

    An embryo has the genetic makeup of a human being, and although immature, some argue that the embryo will grow to develop into a mature human being. Many have religious objections to terminating pregnancies, while others believe that terminating a fetus that has reached viability is akin to extinguishing a human life and should be regulated as such. Actions that limit the potential for life or intentionally terminate a pregnancy, such as contraceptive use or abortion, are considered unjust by some.

  • Laurel Utterback, Bucknell University

    Laurel Utterback, Bucknell University

    Laurel is currently a dual-degree student at Case Western Reserve University. She is completing a J.D. with a concentration in health law as well as an M.A. in Bioethics and Medical Humanities. She received her B.A. in Bioethics and Public Healthcare with minors in Economics and Public Policy from Bucknell University in December 2023. Past research projects include a case study of moral obligations to public health and religious beliefs surrounding COVID-19 vaccines, as well as a statistical and econometric analysis of maternal mistreatment during pregnancy. Right now, she is contributing to a scoping review focused on the operationalization of social support in interventions and evaluation of breastfeeding promotion programs. She is specifically interested in reproductive policy and clinical ethics.

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