Taken from the May/June 2019 issue of the Women's Health Activist Newsletter.
Raising Women’s Voices (RWV)
In 2017, congressional Republicans tried and failed to repeal the ACA and gut Medicaid legislatively. In 2018 and 2019, the Trump-Pence administration picked up where Congress left off, unleashing a barrage of regulatory attacks on public health programs. The executive branch has doubled down on earlier efforts to undermine contraceptive coverage through the ACA, sought to take millions of taxpayer dollars from real family planning clinics (including Planned Parenthood) and give the funds to religiously affiliated fake clinics, tried to punish private insurance plans that cover abortion, and attempted to block legal immigrants and their U.S. citizen relatives from accessing public health care. They encouraged red states to overload Medicaid recipients with bureaucratic red tape designed to block coverage, sought to undermine the ability of people with pre-existing conditions to afford comprehensive insurance, and more. While the government’s final rules have been issued or are expected soon on all these efforts, it’s unclear if the courts will allow them to go into effect.
It can be difficult to mobilize public opinion to fight administrative action, which is less visible and less widely covered than high-drama congressional votes. It can also be disheartening when every day brings a new attack on effective health care programs and policies. But, with the NWHN’s assistance, our 30 state and local regional coordinators in 29 states helped the larger movement to generate hundreds of thousands of public comments opposed to Trump’s policies, raised media awareness about the attacks, helped make health care a major midterm election theme, and advocated for state-based policy responses.
While stopping this administration from issuing terrible rules is often impossible, we’re helping build the strongest possible legal case against them. For example, in response to attempts to gut the Title X family planning program, the NWHN’s Executive Director Cindy Pearson and Policy Advocacy Director Sarah Christopherson met with officials from the Office of Management and Budget to highlight the administration’s failure under the law to evaluate the proposed rule’s real health and economic costs, particularly for women of color. We couldn’t stop the rule from being issued, but we can help the courts block it from going into effect.
Challenging Dangerous Drugs and Devices (CDDD)
The NWHN remains one of the few women’s health organizations focused on the Food and Drug Administration (FDA) that doesn’t accept funding from drug- or device-makers. So, we’re free to speak up when the FDA is pressured to loosen its safety and efficacy standards for women’s health products. In 2019, the NWHN testified at the FDA on the need to require rigorous testing of vaginal mesh products before they’re approved, not after. In 2018, we raised concerns about the uterine fibroid drug Esmya and applauded the FDA when it followed our recommendation and refused to approve it.
Our biggest victory was saving the FDA Office of Women’s Health (OWH). Coded in deceptively bland language and buried in the 31st paragraph of a long explanation of his plans to re-organize the commissioner’s office last year, then-FDA Commissioner Scott Gottlieb tried to (illegally) defund, demote, and prevent the OWH from doing its work. The OWH was created in 1994 in response to women’s demands for the FDA to listen and respond to women’s concerns, especially about the lack of women in clinical trials of FDA-approved products. It’s proven invaluable for responding to consumer concerns and funding critical research. The OWH was codified into law as part of the ACA and can’t be downgraded without congressional authorization. Armed with this knowledge, the NWHN helped organize a successful lightning-speed advocacy campaign to save the OWH that included our congressional allies; Gottlieb was forced to back down within a week. Our work saving the OWH was covered by online publication Rewire in March following Gottlieb’s resignation announcement.
Finally, we parried a pharmaceutical company’s efforts to silence our warnings to women about their ineffective, potentially dangerous product. In late 2018, the makers of flibanserin (brand name Addyi) threatened to take legal action against the NWHN unless we removed all of our on-line Addyi-related materials. It seemed that the company believes our “Pass on the Pink Pill—or Pass Out” campaign, initiated in 2015, played a role in the drug’s poor sales. We simply wanted women to know that the drug isn’t much better than placebo in improving their sex lives and could come with serious side effects.
Securing Sexual and Reproductive Health and Autonomy (SRH)
This spring we rolled out a guide for reproductive health activists responding to state contraceptive policy initiatives—co-written by the NHWN and the National Institute for Reproductive Health. The guide builds on the 2016 Statement of Principles we co-led with SisterSong to address coercion in the provision of long-acting reversible contraceptives (www.tinyurl.com/LARCprinciples). Along with NIRH and Tennessee-based reproductive justice organization SisterReach, we spoke at the Civil Liberties and Public Policy conference in April about the guide and reproductive coercion more broadly.
We’ve also been speaking up about the potential risks posed by Natural Cycles, a fertility awareness app the FDA cleared in 2018. The app is promoted as being as “effective as the Pill,” but there are reasons to question whether the FDA really agrees or was pressured into fast-tracking its clearance. We’re concerned because the Trump-Pence administration has sought to promote religiously acceptable contraceptive methods (like fertility awareness) at the expense of more effective methods in programs (like Title X and teen pregnancy prevention) and in the rule attacking employer contraceptive coverage. (Read more at: https://nwhn.org/smartphone-contraception/.)
Finally, we’ve been active in publicizing medication abortion as a safe and effective way to terminate a pregnancy and defending organizations like Aid Access that help pregnant people self-manage their abortions at home.
Our sexual and reproductive health advocacy work appeared in a range of publications, from the New York Times to online-only publications like Bustle, geared to young women.
Sarah Christopherson is the NWHN’s Policy Director.