NWHN in Action March/April 2020

Taken from the March/April 2020 issue of the Women's Health Activist Newsletter.

Raising Women’s Voices (RWV)

Just when you think the Trump administration has run out of terrible ways to sabotage women’s health care, they come up with another. With the NWHN’s assistance, Raising Women’s Voices’ (RWV) regional coordinators have helped the larger movement generate hundreds of thousands of public comments opposing Trump’s attacks on abortion care coverage through the ACA, immigrant access to health care, red tape and illegal benefit cuts in Medicaid, and more. In many cases, we can’t stop bad rules from being issued, but we can help the courts block them from going into effect for as long as possible.

We’ve also been hard at work ensuring the strongest possible ACA enrollment for 2020. From the very beginning of this administration, we’ve known that one of the best ways to protect the ACA is to make clear, through enrollment, that millions of Americans want and need the affordable and comprehensive coverage that the health law makes possible. Now, a conservative lawsuit backed by the Trump administration has made the link between enrollment and the health law’s survival even more direct. In California v Texas (formerly Texas v Azar), red state attorneys general led by Texas are arguing that, because the 2017 GOP tax bill eliminated the tax associated with the individual mandate, the mandate is now unconstitutional. And, because the law wasn’t originally designed to survive without the mandate, they contend, the courts must strike down the entire law. The only problem for Texas? The law is surviving, even in the face of GOP sabotage. Millions of people continue to enroll in ACA coverage and states continue to work to shore up their ACA implementation and expand Medicaid. With our help, and that of our allies, reality keeps getting in the way of conservatives’ legal theory.

Challenging Dangerous Drugs and Devices (CDDD)

Toxic ingredients and contaminants in cosmetics and other personal care products—like shampoo and conditioner, deodorant, makeup, baby powder, vaginal douches, lotion, body sprays and perfumes, hair dyes and straighteners—have been linked to numerous health problems (see M Isabelle Chaudry’s federal update in this issue). But, with few exceptions, current federal law doesn’t require cosmetics or other personal care products to be approved by the Food and Drug Administration (FDA) before going on the U.S. market.

With our help, that could be changing. In the last few months, we’ve testified in Congress about the dangers of toxic products and the way that some of the most dangerous products are aggressively marketed to Black and Latina women. We’ve testified in front of the FDA about the need for improved testing standards to ensure that cosmetic talc isn’t contaminated with asbestos. We’ve called out a badly done study that was published in the Journal of the American Medical Association and gives women a false sense of security about using talc-based powder for feminine hygiene. We hosted a second webinar and social media campaign with leaders from industry and the environment, women’s health, and reproductive justice communities to help consumers and advocates protect themselves and take action. Our work has been covered in Good Morning America, ABC News, and a number of other outlets.

If that wasn’t enough, we were also at the FDA testifying in support of pulling an ineffective drug from the market. In 2011, the FDA approved 17-hydroxyprogesterone caproate (Makena) with incomplete trial data, because it was (and remains) the only drug of its kind on the market intended to prevent preterm birth in at-risk women. But, subsequent studies have made clear that Makena doesn’t actually work, and may expose pregnant people to unknown side effects. Following our recommendation, an FDA advisory committee recommended withdrawing the drug from the market.

Securing Sexual and Reproductive Health and Autonomy (SRH)

In partnership with the National Institute for Reproductive Health (NIRH), we introduced a Toolkit for reproductive health activists in 2019 to help them respond to contraceptive policy initiatives. The Toolkit builds on our 2016 Statement of Principles, which we co-led with SisterSong, about coercion in the provision of long-acting reversible contraceptives (LARCs). Over the last few months we’ve been finding ways to help spread the word, joining NIRH at the American Public Health Association’s annual conference to talk about the Toolkit, and presenting at the annual Med Students for Choice conference. All of our LARC materials, including the Statement and the Toolkit, are at nwhn.org/larcs.

Finally, the day after the FDA met to consider withdrawing Makena from the market, we were back to testify before a different FDA advisory committee—this time in support of the low-dose contraceptive patch, Twirla. If approved, Twirla would be a significantly lower-dose product than the only other contraceptive patch currently on the market. This would give women a safer choice if they want a user-controlled method that doesn’t have to be taken daily, taken orally, or inserted into the vagina. By a vote of 14 to 1, the committee agreed with our recommendations, with members echoing many of our arguments. On February 14, the FDA released the agency's final decision, approving Twirla and giving us all a nice Valentine’s Day gift. You can find all of our public testimony at nwhn.org/testimony.

Sarah Christopherson, MA, is the Legislative Director for the social justice campaign, Americans for Tax Fairness, and the NWHN’s former Policy Advocacy Director. Her 10 years working for Congress and her deep knowledge of health policy and consumer protection make her the NWHN’s issue area expert on federal health reform implementation and defense, drug and device safety and efficacy, and sexual and reproductive health.

Read more from Sarah Christopherson.