One year since Dobbs decision, the fight for reproductive care isn’t over

The ceiling of the main Rotunda inside Pennsylvania’s Capitol building on Tuesday, May 24, 2022. (Photo by Amanda Berg for the Capital-Star).

Tam St. Claire was a teenager when the U.S. Supreme Court established constitutional protections for abortion with its 1973 decision in Roe v. Wade.

Ann St. Claire, her daughter, didn’t know anything different until June 24, 2022, when the nation’s highest court stripped away federal constitutional protections for abortion with its ruling on Dobbs v. Jackson Women’s Health Organization, giving state legislatures authority over abortion and its legality.

Now, 16-year-old Elise St. Claire, Ann’s daughter, is growing up in a country where access to reproductive care depends on where you live.

“It opened doors for women to be able to have careers, to do things that they wanted to do in their life,” Tam St. Claire, who lives in Bucks County, told the Capital-Star of Roe v. Wade. “My daughter was able to get her master’s degree. We were able to do all these things. It’s terrifying that we have to fight for this again after 50 years.”

Abortion remains safe and legal in Pennsylvania, where the procedure is permitted up to 24 weeks of pregnancy, unless sought based on the sex of the fetus, under the Abortion Control Act. Later exceptions can be made for extraordinary circumstances, including when the health of the person giving birth is at risk.

Still, there’s no guarantee the law will stay that way.

Hundreds of protesters rally in Harrisburg on Saturday, May 14, 2022, to promote abortion access. (Capital-Star photo by Marley Parish)

In the year since the U.S. Supreme Court’s decision to overturn the landmark case, uncertainty and fear of the life-or-death consequences of more restrictive policies brought dozens of advocates — including the St. Claires — to Harrisburg this month as part of a lobbying day for Planned Parenthood Pennsylvania Advocates, the political arm of the reproductive care organization.

“All of us, no matter our age, gender, or affiliation, should have access to health care, and abortion is health care,” Ann St. Claire, who lives in Montgomery County, said. “We want to make sure that is secured for generations to come.”

Advocates have demanded accountability from lawmakers — especially Gov. Josh Shapiro and fellow Democratic lawmakers who now control the state House of Representatives for the first time in 12 years — and pushed them to follow through on promises made on the campaign trail to maintain and expand access to reproductive health care.

As Planned Parenthood Pennsylvania Advocates Executive Director Signe Espinoza put it, they are “activating a new kind of pink.” They aren’t asking for protections and expanded reproductive health access anymore; they’re demanding them.

“They need to show up for us all other 364 days, not just on Election Day,” Espinoza said of lawmakers.

Turning out to move beyond the status quo

Without federal abortion protections, stricter policies or a total ban in Pennsylvania became real possibilities last year, despite Pennsylvanians supporting keeping abortion legal under all or some circumstances.

During his gubernatorial campaign last year, Sen. Doug Mastriano, R-Franklin, called legal abortion “a national catastrophe” and vowed to push his six-week abortion ban if elected. He also voiced support for punishing doctors who perform abortions.

Shapiro — whose office did not respond to repeated requests for comment — promised to uphold the legacy of former Gov. Tom Wolf by vetoing any legislation to restrict or outlaw abortion but declined to answer questions about expanding abortion access.

“We’ll cross that bridge when we come to it,” Shapiro told reporters hours after the ruling. “What we now know is that we are in a position where bill after bill taking away these fundamental freedoms is making its way to Gov. [Tom] Wolf’s desk and likely [making] its way to my desk.”

Roe’s reversal put abortion access on the ballot, and Democrats staked their campaigns on the issue, promising voters to protect the procedure. Shapiro easily secured Planned Parenthood’s endorsement in the governor’s race, which he won by more than 700,000 votes. And when political control of the House came down to a special election, Shapiro, and President Joe Biden, showed their support for the Democratic candidate.

“Vote to keep abortion legal,” Shapiro said in an advertisement backing now-state Rep. Heather Boyd, D-Delaware, ahead of the election.

Pennsylvania Gov . Josh Shapiro delivers his first budget address to a joint session of the state House and Senate on March 7, 2023 (Photo by Amanda Mustard for the ). Pennsylvania Gov . Josh Shapiro delivers his first budget address to a joint session of the state House and Senate on March 7, 2023 (Photo by Amanda Mustard for the ).

During his first week in office, Shapiro met with Planned Parenthood Pennsylvania Advocates and its three affiliates in the commonwealth to discuss improving access for patients — regardless of their financial situation — removing limitations and hurdles for care providers.

Advocates also want to remove some testing requirements for patients and for the state to stop allocating funds to pay for so-called crisis pregnancy centers, whose supporters say they offer alternatives to abortion and critics accuse of using deceptive practices to dissuade people from terminating a pregnancy.

In February, he joined other Democratic governors in the multi-state Reproductive Freedom Alliance to protect abortion and reproductive health care access in the wake of the U.S. Supreme Court decision.

The Shapiro administration also launched a website to provide facts and resources about their abortion rights in April, responding to a Texas case about the Federal Drug Administration’s approval of a drug used in medication abortions.

Reflecting on the last year, Espinoza, though happy to have a Democrat in the governor’s office and one Democratically-controlled chamber, is frustrated by legislative inaction.

“We’re so grateful that, yet again, abortion voters showed up because this is important to them,” Espinoza told the Capital-Star. “But we know that maintaining the status quo and not pushing on our issues is really making it so that this state falls short.”

As budget negotiations with lawmakers and Shapiro play out this month, state Rep. Ismail Smith-Wade-El, a first-term lawmaker from Lancaster County, said Democrats are pushing for increased investments in childcare, such as higher wages for childcare workers and affordability.

Describing a budget as a “moral document,” Smith-Wade-El told the Capital-Star that “unless we’re talking about that whole spectrum, we’re really not talking about reproductive justice.”

Shapiro’s $44.4 billion proposed budget includes roughly $6 million for the so-called crisis pregnancy centers, including a $1 million allotment from the Temporary Assistance for Needy Families line item, which aims to support low-income households.

That is similar to what Wolf signed during his last year in office, giving more than $7.2 million to Real Alternatives, an anti-abortion organization with clinics statewide.

Dayle Steinberg, president and CEO of Planned Parenthood of Southeastern Pennsylvania speaks during a press conference in Philadelphia on May 4, 2022. (Commonwealth Media Services)

Pennsylvania is one of a handful of states that allocates the federal TANF funding earmarked for families in extreme poverty to the centers, and it’s sparked controversy for years.

In April, advocates urged elected leaders to stop giving the centers taxpayer money, calling for an investigation “not a $6 million handout,” Espinoza said.

Elizabeth Rementer, a spokesperson for House Democrats, told the Capital-Star that the caucus does not support allocating taxpayer funds to organizations that “provide inaccurate information to pregnant people,” adding that lawmakers plan to continue advocating for “guardrails around the funds provided to these organizations.”

With less than 20 freestanding abortion clinics left in Pennsylvania, which has 67 counties, advocates are concerned about access to resources, including abortion procedures, primary care services, HIV treatment, STD testing and treatment, and gender-affirming care. Most patients receive care at a Planned Parenthood facility for free or at a reduced cost. 

In emergencies or instances where patients have to travel hundreds of miles, the current clinics aren’t enough, Planned Parenthood Southeastern Pennsylvania CEO Dayle Steinberg said.

“We need to be better for the patients we serve,” Steinberg said. “We owe it to them, and we will continue to deliver with the Legislature’s help.”

Navigating a Divided Legislature

Lawmakers have introduced bills to require safeguards and reporting for organizations offering pregnancy-related services, remove restrictions, create abortion protections, and expand access to contraceptives.

So far this session, neither chamber has approved an abortion-related bill, notably the House, which has a razor-sharp Democratic majority and where lawmakers have said they want to prioritize maternal and child health, workplace equality, economic empowerment for women, issues of domestic violence and sexual assault, and protections for LGBTQ+ Pennsylvanians.

“House Democrats have time and time again demonstrated our commitment to protecting a woman’s access to reproductive health, both by halting dangerous bills that jeopardize that right and by introducing legislation to further improve access,” Rementer said, describing former Gov. Tom Wolf and Shapiro as allies in their efforts. “As the majority, we, too, are in a strong position to both protect and improve reproductive health for Pennsylvanians.”

Freshman state Rep. La’Tasha D. Mayes, D-Allegheny, worked as a reproductive justice advocate before coming to Harrisburg. Mayes, who now serves on the Women’s Health Caucus, told the Capital-Star that she wants to see legislation that builds on Roe v. Wade, saying lawmakers should examine ways to be more proactive and intersectional when it comes to policy.

“In our conversations about reproductive health rights and justice, we’re connecting it to gender-affirming care for trans youth,” she said. “We’re connecting it to Black maternal health. We’re connecting it to environmental justice and climate change.”

Sen. Amanda Cappelletti, D-Delaware, has worked on legislation to offer insurance coverage for infertility services. She’s been a vocal advocate for abortion access, and her own miscarriages experience has her planning a bill that would give paid leave for pregnancy loss.

Sen. Amanda Cappelletti, D-Delaware, speaks during a press conference in Philadelphia on May 4, 2022. (Commonwealth Media Services)

Though she shares some disappointment voiced by reproductive health advocates, Cappelletti recognizes the challenges that come with a politically divided Legislature.

“We still have a Senate that is completely Republican, and they’re not going to move any of these bills even if it goes through the House,” she told the Capital-Star. “It would certainly send a message, and I would love to see that if we did pass them out of the House, but I also understand that we need to find things that we can compromise on.”

Mayes said House Democrats want to find ways to work across the aisle on legislation, but she added: “If it takes 102, it takes 102,” referring to the Democrats’ one-seat majority in the lower chamber.

A divided General Assembly does mean that pushing constitutional amendments, a method predominantly used by GOP lawmakers to side-step a gubernatorial veto, becomes harder, requiring both chambers to pass identical language in two consecutive sessions to reach voters.

Last year, GOP lawmakers and a handful of Democrats voted to approve a five-part amendment package that, if approved by voters, would amend the state Constitution to declare there is “no constitutional right to taxpayer-funded abortion or other right relating to abortion.”

Language for the abortion-related proposal came from a bill introduced by Sen. Judy Ward, R-Blair, a former nurse, who — along with others who supported the package — said existing law wouldn’t change immediately. They also argued that a ballot question gives voters the ultimate say on abortion access in Pennsylvania.

Democratic lawmakers and abortion rights advocates rally on the Pennsylvania Capitol steps on Tuesday, Sept. 20, 2022. (Capital-Star photo by Marley Parish)

Even though the constitutional amendment package is unlikely to move in a divided Legislature, state Rep. Mary Jo Daley, D-Montgomery, who co-chairs the Women’s Health Caucus, sees the amendment as a sign that there’s more work to be done. 

“We’re not seeing abortion bills being brought up because we feel, I think, really good with where we are,” Daley said. “What we’ve been able to do as the Women’s Health Caucus is focus on legislation that — for all those years — we couldn’t get through committee.”

Daley said the caucus is specifically focused on maternal and child health, workplace equality, economic empowerment for women, issues of domestic violence and sexual assault, and protections for LGBTQ+ Pennsylvanians.

Reproductive rights advocates and medical providers said the proposed amendment would impose an abortion ban across the commonwealth, arguing that medical decisions should be between patients and their doctors, not the general public.

Since the 2022 general election, Pennsylvania lawmakers have not advanced that specific amendment. After the Dobbs decision, voters in five states moved to either enshrine abortion access into their constitutions or reject restrictions.

However, they did wrap language proposing sweeping legislative authority over regulations into a three-part amendment package, Senate Bill 1, which some lawmakers and advocates fear could let elected officials change the regulatory conditions that allow providers to offer abortion care.

“It is just another angle,” Cappelletti said, adding that bill text can create inconspicuous mandates and policies. “You really have to stop and read the language.”

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Originally published at www.penncapital-star.com,by Marley Parish

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