    [House Hearing, 112 Congress]
    [From the U.S. Government Publishing Office]

                   CHILD INTERSTATE ABORTION NOTIFICATION ACT

    =======================================================================

                                    HEARING

                                   BEFORE THE

                        SUBCOMMITTEE ON THE CONSTITUTION

                                     OF THE

                           COMMITTEE ON THE JUDICIARY

                            HOUSE OF REPRESENTATIVES

                          ONE HUNDRED TWELFTH CONGRESS

                                 SECOND SESSION

                                       ON

                                   H.R. 2299

                                   __________

                                 MARCH 8, 2012

                                   __________

                               Serial No. 112-87

                                   __________

             Printed for the use of the Committee on the Judiciary

          Available via the World Wide Web: http://judiciary.house.gov

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                           COMMITTEE ON THE JUDICIARY

                          LAMAR SMITH, Texas, Chairman
    F. JAMES SENSENBRENNER, Jr.,         JOHN CONYERS, Jr., Michigan
        Wisconsin                        HOWARD L. BERMAN, California
    HOWARD COBLE, North Carolina         JERROLD NADLER, New York
    ELTON GALLEGLY, California           ROBERT C. ``BOBBY'' SCOTT,
    BOB GOODLATTE, Virginia                  Virginia
    DANIEL E. LUNGREN, California        MELVIN L. WATT, North Carolina
    STEVE CHABOT, Ohio                   ZOE LOFGREN, California
    DARRELL E. ISSA, California          SHEILA JACKSON LEE, Texas
    MIKE PENCE, Indiana                  MAXINE WATERS, California
    J. RANDY FORBES, Virginia            STEVE COHEN, Tennessee
    STEVE KING, Iowa                     HENRY C. ``HANK'' JOHNSON, Jr.,
    TRENT FRANKS, Arizona                  Georgia
    LOUIE GOHMERT, Texas                 PEDRO R. PIERLUISI, Puerto Rico
    JIM JORDAN, Ohio                     MIKE QUIGLEY, Illinois
    TED POE, Texas                       JUDY CHU, California
    JASON CHAFFETZ, Utah                 TED DEUTCH, Florida
    TIM GRIFFIN, Arkansas                LINDA T. SANCHEZ, California
    TOM MARINO, Pennsylvania             JARED POLIS, Colorado
    TREY GOWDY, South Carolina
    DENNIS ROSS, Florida
    SANDY ADAMS, Florida
    BEN QUAYLE, Arizona
    MARK AMODEI, Nevada

               Richard Hertling, Staff Director and Chief Counsel
           Perry Apelbaum, Minority Staff Director and Chief Counsel
                                     ------

                        Subcommittee on the Constitution

                        TRENT FRANKS, Arizona, Chairman

                       MIKE PENCE, Indiana, Vice-Chairman

    STEVE CHABOT, Ohio                   JERROLD NADLER, New York
    J. RANDY FORBES, Virginia            MIKE QUIGLEY, Illinois
    STEVE KING, Iowa                     JOHN CONYERS, Jr., Michigan
    JIM JORDAN, Ohio                     ROBERT C. ``BOBBY'' SCOTT,
                                         Virginia

                         Paul B. Taylor, Chief Counsel

                    David Lachmann, Minority Staff Director

                                C O N T E N T S

                                  ----------

                                 MARCH 8, 2012

                                                                       Page

                                    THE BILL

    H.R. 2299, the ``Child Interstate Abortion Notification Act''....     3

                               OPENING STATEMENTS

    The Honorable Trent Franks, a Representative in Congress from the
      State of Arizona, and Chairman, Subcommittee on the
      Constitution...................................................     1
    The Honorable Jerrold Nadler, a Representative in Congress from
      the State of New York, and Ranking Member, Subcommittee on the
      Constitution...................................................    15

                                   WITNESSES

    Teresa Stanton Collett, Professor of Law, University of St.
      Thomas School of Law
      Oral Testimony.................................................    18
      Prepared Statement.............................................    21
    The Very Rev'd. Katherine Hancock Ragsdale, President and Dean,
      Episcopal Divinity School
      Oral Testimony.................................................    41
      Prepared Statement.............................................    43
    Michael J. New, Ph.D., Department of Social Sciences, University
      of Michigan--Dearborn
      Oral Testimony.................................................    49
      Prepared Statement.............................................    51

              LETTERS, STATEMENTS, ETC., SUBMITTED FOR THE HEARING

    Prepared Statement of the Honorable Lamar Smith, a Representative
      in Congress from the State of Texas, and Chairman, Committee on
      the Judiciary..................................................    16

                                    APPENDIX
                   Material Submitted for the Hearing Record

    Prepared Statement of the Honorable Trent Franks, a
      Representative in Congress from the State of Arizona, and
      Chairman, Subcommittee on the Constitution.....................    69
    Prepared Statement of the Honorable Ileana Ros-Lehtinen, a
      Representative in Congress from the State of Florida...........    71
    Response to Post-Hearing Questions from Teresa Stanton Collett,
      Professor of Law, University of St. Thomas School of Law.......    72
    Response to Post-Hearing Questions from the Very Rev'd. Katherine
      Hancock Ragsdale, President and Dean, Episcopal Divinity School    76
    Prepared Statement of Americans United for Life, submitted by the
      Honorable Trent Franks, a Representative in Congress from the
      State of Arizona, and Chairman, Subcommittee on the
      Constitution...................................................    83
    Material submitted by the Honorable Jerrold Nadler, a
      Representative in Congress from the State of New York, and
      Ranking Member, Subcommittee on the Constitution
        Prepared Statement of the National Latina Institute for
          Reproductive Health........................................   104
        Prepared Statement of the American Civil Liberties Union
          (ACLU).....................................................   109
        Letter in opposition to H.R. 2299, the ``Child Interstate
          Abortion Notification Act''................................   115
        Prepared Statement of the Center for Reproductive Rights.....   117
        Letter in opposition to H.R. 2299, the ``Child Interstate
          Abortion Notification Act''................................   134
        Prepared Statement of the National Abortion Federation.......   137
        Prepared Statement of the National Partnership for Women &
          Families (PRCH)............................................   140
        Prepared Statement of the Physicians for Reproductive Choice
          and Health.................................................   145
        Prepared Statement of the Reproductive Health Technologies
          Project....................................................   149

                   CHILD INTERSTATE ABORTION NOTIFICATION ACT

                                  ----------

                            THURSDAY, MARCH 8, 2012

                      House of Representatives,
                      Subcommittee on the Constitution,
                                    Committee on the Judiciary,
                                                        Washington, DC.

        The Subcommittee met, pursuant to call, at 9:41 a.m., in
    room 2141, Rayburn Office Building, the Honorable Trent Franks
    (Chairman of the Subcommittee) presiding.
        Present: Representatives Franks, King, Jordan, Nadler,
    Scott, and Quigley.
        Staff present: (Majority) Paul Taylor, Subcommittee Chief
    Counsel; Jacki Pick, Counsel; Sarah Vance, Clerk; (Minority)
    David Lachmann, Subcommittee Staff Director; and Veronica
    Eligan, Professional Staff Member.
        Mr. Franks. Good morning, and welcome to this Constitution
    Subcommittee hearing on H.R. 2299, the ``Child Interstate
    Abortion Notification Act.''
        Without objection, the Chair is authorized to declare the
    recess of the Committee at any time.
        The Child Interstate Abortion Notification Act, more
    commonly known as CIANA, is a very reasonable measure that
    would prevent the transportation of a minor across State lines
    in circumvention of a parental consent law that applies to a
    minor's abortion procedure. This law is consistently supported
    by 70 percent of the American people in national opinion polls.
        More than 30 States have made it clear through legislation
    that parents have the right to know whether their minor
    daughters are trying to undergo an abortion. Parents play a
    critical role in the well-being of their daughters,
    particularly in such a context. And I would quote the bill
    sponsor, Ms. Ros-Lehtinen, ``As a mother and a grandmother, I
    understand the importance of the unconditional love and support
    that parents can give to their children. This responsibility is
    nonnegotiable and nontransferable. This bill assures young
    women that they are not alone, if ever they find themselves
    contemplating undergoing an abortion.''
        Parental notification laws have proven to be effective at
    lowering the abortion rate among minors, and, therefore, they
    are effective at lowering the attending risks that accompany
    abortion.
        Abortion is a serious surgical procedure with serious
    physical and psychological risks, some of which can be
    especially detrimental when experienced at a young age. These
    include increased risks of breast cancer, extremely premature
    birth in subsequent pregnancy--that is, delivering at 28 weeks
    of gestation or less--and suicide.
        When a woman experiences an abortion early in life, she can
    lose the protective effect against breast cancer that full-term
    pregnancy provides through inherent changes in breast tissue.
    Many developed countries legalized abortion in the early
    1970's, and breast cancer rates have increased as much as 80
    percent since then in these same countries.
        Likewise, when a woman has one induced abortion, she is 50
    to 70 percent more likely to experience an extremely premature
    birth, again, defined as a delivery at 28 weeks or earlier,
    when she later attempts to carry a wanted child to term. This
    could be due to damage to the cervix during the abortion,
    rendering it less competent.
        When a woman has two abortions, she becomes 160 percent
    more likely to have an extremely premature birth. An extremely
    premature birth carries greatly increased risks for many
    serious health issues. For example, babies who are extremely
    premature have 38 times the risk of cerebral palsy than babies
    born full-term. And there are increased risks for autism and
    mental retardation.
        Abortions performed on African-American women are
    approximately five times the rate of Caucasian women. And,
    consequently, African-American women have four times the risk
    of extremely premature birth.
        It is also true that the danger of subsequent premature
    birth is significantly greater when an abortion is performed on
    a girl under 17 years of age.
        Premature birth rates are now up more than 43 percent since
    Roe v. Wade became law. Forty-nine studies worldwide have
    confirmed this causal link between abortion and premature
    birth. Abortion and suicide are also correlated.
        A study by two economists appearing in the January 18th,
    2012, online version of the Journal of Economic Inquiry shows
    that parental involvement laws correlate with a decrease in the
    incidence of teen suicide. Quote, ``The adoption of a law
    requiring a parent's notification or consent before a minor can
    obtain an abortion is associated with an 11 to 21 percent
    reduction in the number of 15- through 17-year-old females who
    commit suicide,'' unquote.
        Ladies and gentlemen, we have a responsibility to ensure
    that parents are able to protect their minor daughters from an
    invasive surgical procedure that takes the life of their
    grandchild and sometimes brings with it additional,
    significant, and deadly hidden costs. This bill is a step in
    that direction.
        And I would now recognize the Ranking Member for 5 minutes
    for an opening statement.
        [The bill, H.R. 2299, follows:]

                                   __________
        Mr. Nadler. Thank you, Mr. Chairman.
        Today we consider legislation that is at once another
    flagrant violation of the Constitution and an assault on the
    health and well-being of young women and the health care
    providers.
        Before we start discussing this bill, versions of which we
    have considered in the 105th, 106th, 107th, 108th, and 109th
    Congresses, and I presume will have no more success in this
    Congress, I think it is important to note that this is the
    ninth time this Committee has met in this Congress to assault
    the reproductive rights of women.
        The 112th Congress has had just over 200 legislative days
    so far. If the Republican leadership had put as much effort
    into helping distressed homeowners or creating jobs or
    reforming our immigration laws as they have into the war on
    women, most of our problems might have been solved by now.
        Instead, we get this warmed over and facially
    unconstitutional legislation yet again. Some States have chosen
    to enact parental notification or consent laws. Some, like
    mine, have considered this issue and decided it is not good for
    the welfare of young women and have declined to do so.
        This bill would substitute the judgment of Congress for the
    judgment of people who live in States like mine. In fact, even
    where the young women's State of residence and the State in
    which the doctor is located have both decided not to enact such
    laws, this bill would impose a new Federal parental
    notification law that is more draconian and more
    unconstitutional than the laws of most States.
        Perhaps we should just disband our State legislatures and
    let Washington decide these important family issues for us. If
    it would spare the rest of us endless speeches about federalism
    and State's rights, I might be tempted to go along with it.
        I would just note, in this regard, that many Members of
    this Committee recently voted to allow the laws of some States
    to preempt the concealed carry firearm laws in other States,
    including mine. Congress would, in effect, allow any State to
    nullify our laws and require us to allow anyone lunatic to walk
    our streets with a concealed weapon if so much as one other
    State says they can.
        As a matter of policy, this bill would place many young
    women in an impossible situation. In some cases, the young
    woman may not be able to go to her parents and can turn only to
    a grandparent, a sibling, or a member of the clergy. Indeed,
    sometimes the parents may pose a threat to the life and health
    of the young woman, if they learn that she is pregnant.
        That is what happened to Spring Adams, a 13-year-old from
    Idaho. She was shot to death by her father after he found out
    that she planned to terminate her pregnancy, one he caused by
    his act of incest.
        I would commend the authors of the bill for not allowing
    him to sue in this new version of the bill. It is a step in the
    right direction from the prior versions of the bill, albeit a
    small step.
        This bill also uses a narrow definition of medical
    emergencies that applies only where, ``abortion was necessary
    to save the life of the minor because her life was endangered
    by a physical disorder, physical injury, or physical illness,
    including a life-endangering physical condition caused by or
    arising from the pregnancy itself.''
        That clearly falls far short of the Supreme Court's
    requirement that any restriction on the right to choose must
    have an explicit exception to protect the life or health of the
    woman.
        There are many things far short of death that threaten a
    young woman. She deserves prompt and professional medical care,
    and the Constitution still protects her right to receive that
    care. Requiring that young women have their health destroyed is
    beyond cruel. It is anything but pro-life.
        I know that I have rankled some of my colleagues in the
    past by comparing this bill to the fugitive slave law. I would
    never suggest that this bill turns young women into slaves, so
    don't say that I did. I won't even presume to know what
    Frederick Douglass might think of this bill.
        But by requiring a young woman or any American to carry the
    law of their States on their backs as they travel around the
    country to other States is inimical to our Federal system. We
    have a few laws in New York that I think might benefit the
    people of other States, but I am not sure the proponents of
    this legislation would particularly like it.
        I know of no laws since the Fugitive Slave Act that
    literally says that you take the law of the State from which
    you leave when you go to some other State, and use the power of
    the Federal Government to enforce the law of the first State in
    the jurisdiction of the second State.
        So when she goes from State A to State B, and State B
    allows abortions, let's say without parental notification, this
    bill says that that is illegal and that the doctor who performs
    the abortion in the State where it is perfectly legal to do so
    without parental notification commits a crime because of the
    law in the other State.
        So this bill uses the power of the Federal Government to
    export the law of one State, to enforce it another against the
    public policy of the State. And as I said, I know of no law
    since the Fugitive Slave Act that attempted to use the power of
    the Federal Government in exporting the law of one State to
    another State.
        Congress, in any event, should not be tempted to play
    doctor. It is always bad medicine for women. This
    unconstitutional and ill-considered legislation will harm young
    women.
        But perhaps the intention is to punish young women who
    desire to have abortions. In fact, that seems to be the
    intention of a lot of legislation, so maybe it is not ill-
    considered. Maybe it is simply ill-motivated.
        I look forward to the testimony of our witnesses, and yield
    back the balance of my time.
        Mr. Franks. Without objection, other Members' opening
    statements will be made a part of the record.
        [The prepared statement of Mr. Smith follows:]
     Prepared Statement of the Honorable Lamar Smith, a Representative in
       Congress from the State of Texas, and Chairman, Committee on the
                                   Judiciary
        Across the country, officials must obtain parental consent before
    children can engage in certain school activities such as field trips
    and contact sports.
        In nearby Maryland, school systems even require a parent's note
    before sunscreen can be applied to a student.
        And my home state of Texas, along with the large majority of
    states, requires parental consent before anyone can tattoo a minor.
        Abortion is a serious medical procedure. And most states--my home
    state of Texas included--have some form of parental involvement law
    that requires that at least one parent be given notice, or give their
    consent, before their minor daughter receives an abortion.
        Yet today, it remains legal for complete strangers to evade those
    state parental involvement laws and transport minors across state lines
    to obtain secret abortions without the minor's parents ever knowing
    about it.
        Because this tragic gap in the law involves interstate commerce,
    under the Constitution, only Congress can address it. The Child
    Interstate Abortion Notification Act ensures state parental involvement
    laws are not evaded through interstate activity.
        Parental involvement in the abortion decisions of minor girls leads
    to improved medical care for minors who seek abortions, and provides
    increased protection for young girls against sexual exploitation by
    adult men.
        Parental involvement ensures that parents have the opportunity to
    provide medical history and other information to abortion providers
    prior to the performance of an abortion.
        The medical, emotional and psychological consequences of an
    abortion are serious and lasting. An adequate medical and psychological
    case history is critically important to any physician, and often only
    parents can provide such information for their daughters as well as any
    suitable family medical history.
        Parental involvement also improves medical treatment of pregnant
    minors. It ensures that parents have adequate knowledge to recognize
    and respond to any post-abortion complications that may develop.
        Without the knowledge that their daughters have had abortions,
    parents are unable to ensure that their children obtain routine
    postoperative care.
        Finally, teenage pregnancies often occur as a result of predatory
    practices of men who are usually much older than their minor victim.
    This results in the transportation of victims across state lines by an
    individual who has a great incentive to avoid criminal liability for
    his conduct.
        Parental involvement laws ensure that parents have the opportunity
    to protect their daughters from those who would victimize them further,
    and the bill under discussion today does just that.
        The House passed this legislation with large bipartisan support
    when it was last brought up for a vote. I hope and expect it will enjoy
    the same broad support this year.
                                   __________

        Mr. Franks. And I certainly hope people listen very
    carefully to statements like this and think through it.
        Witnesses, thank you for being here this morning. We
    welcome you.
        Dr. Teresa Collett is a professor of bioethics and
    professional responsibility at the University of St. Thomas
    School of Law. Professor Collett is an elected member of the
    American Law Institute, and she has testified before committees
    of the United States Senate and House of Representatives, as
    well as before State legislative committees.
        Most recently, she represented various medical groups in
    the defense of the Federal ban of partial-birth abortion and
    the Governors of Minnesota and North Dakota in a parental
    consent case before the United States Supreme Court. She has
    served as a special attorney general for the States of Oklahoma
    and Kansas, and has assisted other States attorneys general in
    defending laws protecting human life and marriage.
        And, welcome, Professor Collett.
        The Very Rev. Dr. Katherine Hancock Ragsdale was appointed
    president and dean of Episcopal Divinity School in Cambridge,
    Massachusetts, in March of 2009. Dean Ragsdale has appeared on
    William F. Buckley's Firing Line, Faith Under Fire, Religion
    and Ethics, and many other broadcasts.
        Dean Ragsdale served on the national boards of NARAL, Pro-
    choice America. She is the editor of ``Boundary Wars: Intimacy
    and Distance in Healing Relationships,'' and the author of
    ``The Role of Religious Institutions in Responding to the
    Domestic Violence Crisis.''
        Welcome, Dean Ragsdale.
        Dr. Michael New is an assistant professor of political
    science at the University of Michigan-Dearborn, a Phi Beta
    Kappa graduate of Dartmouth College. He holds a master's degree
    in statistics and a Ph.D. in political science from Stanford
    University. He completed his postdoctoral research at the MIT
    Harvard Data Center.
        Dr. New's research interests span from campaign finance
    reform to the positive impact of pro-life legislation and
    States' informed consent laws, Medicaid funding rules and
    parental notification laws for minors.
        His work has been featured in peer-reviewed scholarly
    journals, such as the State Politics & Quarterly Policy and in
    major media outlets such as National Review Online, the Weekly
    Standard, and the New York Post.
        I want to thank all witnesses, again, for appearing before
    us today. Each of the witness's written statements will be
    entered into the record in its entirety, and I would ask that
    each witness summarize his or her testimony in 5 minutes or
    less. And to help you stay within that time, there is a timing
    light on your table. When the light switches from green to
    yellow, you will have 1 minute to conclude your testimony. When
    the light turns red, it signals that witness's 5 minutes have
    expired.
        Before I recognize the witnesses, it is the tradition of
    this Committee that they be sworn, so if you will please stand
    to be sworn.
        [Witnesses sworn.]
        Mr. Franks. Thank you, and please be seated.
        I will recognize our first witness, Professor Collett, for
    5 minutes.
        Pull your microphone closer to you maybe. Is that on?

        TESTIMONY OF TERESA STANTON COLLETT, PROFESSOR OF LAW,
                 UNIVERSITY OF ST. THOMAS SCHOOL OF LAW

        Ms. Collett. Mr. Chairman, other Members of the Committee
    and distinguished guests, I am delighted to appear to testify
    in favor of this important piece of legislation related to the
    health care of minors.
        I am a professor of law at the University of St. Thomas in
    Minnesota. My opinions I express here today do not represent
    the university or any other organization or person. They are
    opinions, however, that I have derived by virtue of my
    scholarly studies of the operation of parental involvement
    laws, as well as my practice in litigation in representing
    States defending their parental involvement laws.
        This particular piece of legislation has appeared before
    this Committee numerous times, as Congressman Nadler mentioned.
    In fact, it is a common-sense piece of legislation that
    represents the consensus across the country. Thirty-seven
    States currently have parental involvement laws in effect, and
    another six States have passed them but had them enjoined by
    judicial action or by an opinion of their State attorney
    general.
        These laws are based on common-sense protection of girls in
    recognition of the particular health benefits that derive from
    them.
        First and foremost, as the United States Supreme Court
    itself has observed, parental involvement allows the parent to
    provide needed medical history and details to a physician who
    is about to undertake treatment of their minor daughter. It
    also allows the parent to guide that minor in the selection of
    an abortion provider, knowing the difference between a
    competent doctor as opposed to someone who is simply practices
    in this area to generate money and engages in unsanitary
    conduct.
        Second, they allow the opportunity of those parents to
    ensure that the girl's well-being is properly considered by
    that abortion provider.
        And finally, and I believe most importantly, as the Supreme
    Court has observed, it ensures that the parents have the
    ability to monitor for post-abortion complications.
        The Chairman mentioned particularly surgical abortions, but
    surgical abortions are not the only form of abortion being
    engaged in by abortion clinics today. There are also abortions
    using RU-486, which was approved for use by the FDA but had not
    been tested on the use of minors. There has been no follow-up
    study, notwithstanding the FDA's requirement that such studies
    be submitted to the FDA on the use of RU-486 for minors.
        Therefore, it is of critical importance that parents know
    about the medical condition of their minor, as well as about
    the medical treatment that has been undertaken, so that they
    can monitor for adverse effects, such as hemorrhaging or
    infection, the primary adverse side effect from abortion.
        The Ranking Member mentioned the need on occasion for an
    emergency abortion. In a study that I did in preparation for my
    testimony as an expert witness in Alaska, I actually looked for
    State records regarding the number of emergency bypasses done
    related to abortion of any kind, and there are few States that
    actually report that to the departments of health. Among them
    are Alabama, Nebraska, and Wisconsin.
        What those States reported in the period from 2005 to 2010
    is that were over a total of four--four--emergency abortions.
    In Alabama, the number of abortions ranged from 781 to 654
    during that time period. In 2005, there was exactly one
    emergency bypass. In 2006, there was exactly one emergency
    bypass. And from 2007 to 2010, none.
        In Wisconsin, the number was zero for a 5-year period. And
    in Nebraska, the number was one in a 5-year period.
        This legislation is obviously constitutional and relies on
    the long-standing Supreme Court precedent that allows Congress
    to correct the problems that can be created in federalism.
        The State of Missouri, for example, attempted to create a
    statute that precluded intentionally taking a minor out of
    State in order to obtain abortion and avoid that State's
    parental consent law. In reviewing the law, the Missouri
    Supreme Court upheld it only in so far as it applied in State,
    but it could not reach the conduct of abortion providers in
    Illinois who were actively advertising for girls to cross State
    lines to avoid parental consent.
        This law is no different than the law upheld by the Supreme
    Court in Caminetti, which forbids the transport of women across
    State lines for immoral purposes, or any other numerous laws.
        If FACE is constitutional, a favorite of abortion
    activists, then certainly this law is constitutional.
        Thank you, Mr. Chairman.
        [The prepared statement of Ms. Collett follows:]

                                   __________
        Mr. Franks. Thank you, Professor Collett.
        And Rev. Ragsdale, please, for 5 minutes.

       TESTIMONY OF THE VERY REV'D. KATHERINE HANCOCK RAGSDALE,
             PRESIDENT AND DEAN, EPISCOPAL DIVINITY SCHOOL

        Rev. Ragsdale. Chairman Franks, Ranking Member----
        Mr. Franks. Rev. Ragsdale, would you pull that in and push
    the button? That will work.
        Rev. Ragsdale. Thank you very much.
        Mr. Franks. Yes, ma'am.
        Rev. Ragsdale. And thank you for the opportunity to testify
    once again on this bill.
        I come before you as an Episcopal priest with over 15 years
    in parish ministry, now serving as president of one of the
    Episcopal Church's 10 seminaries. My interest in and
    perspective on this issue are shaped by my life as a parish
    priest, by my current work educating future priests, and by my
    responsibilities as an Episcopalian, because this bill flies in
    the face of, is completely contrary to, the official position
    of the Episcopal Church.
        I recall vividly one day when I left my home to pick up a
    15-year-old girl and drive her to Boston for an 8 a.m.
    appointment for an abortion. I didn't know the girl. I knew her
    school nurse. The nurse had called me a few days earlier to see
    if I knew where she might find money to give the girl for bus
    fare to and cab fare home from the hospital. I was stunned.
        A 15-year-old was going to have to get up at dawn and take
    multiple buses to the hospital alone. The nurse shared my
    concern but explained that the girl had no one to turn to. She
    feared for her safety if her father found out, and there were
    no other relatives close enough to help.
        There was no one to be with her, so I went, and during our
    hour-long drive, we talked. She told me about her dreams for
    the future, all the things she thought she might like to do and
    be. I talked to her about the kind of hard work and personal
    responsibility it would take to get there. She talked to me
    about her guilt at being pregnant. I talked to her about God.
        Later, I drove her back to her school and walked her to the
    nurse's office and turned her over to someone who would look
    out for her for the rest of the day, and I drove home wondering
    how many bright, funny, thoughtful, girls, girls brimming with
    promise, had no one to help them.
        I did not take her across State lines, nor did I, to my
    knowledge, break any laws. But if either of those things had
    been necessary to help that girl, I would have done them.
        And if helping young women like her should be made illegal,
    I will nonetheless continue to do it. I have no choice.
        Some years ago, I stood before an altar and a bishop of the
    people of God, and vowed to love and serve the people among
    whom I work. Even if you tell me that it is a crime to exercise
    my ministry, I will have no choice. And I assure you, I am not
    alone.
        I would like to acknowledge that we probably all have much
    in common here: although we may differ as to when, if ever,
    abortion is a morally appropriate choice, I wish we could all
    acknowledge the fact that it is a legally protected choice.
    And, certainly, we can all agree that we would like for all
    women to have fewer reasons to consider abortion, and we all
    deeply desire that every teen facing any significant decision
    be able to turn to her parents for guidance and support.
        That is the world we wish for. The Episcopal Church,
    certainly, hopes and works for such a world even as we passed a
    resolution opposing parental notification laws, because we know
    that, unfortunately, for far too many young women, this is not
    the world they actually live in and must find a way to
    navigate.
        We know that young women do get pregnant, sometimes due to
    poor choices or carelessness, too often due to violence or
    coercion. And while you surely know the statistics that an
    overwhelming majority of minor women considering an abortion
    do, indeed, talk to their parents, some won't and others can't.
        That is why many years ago now the Episcopal Church passed
    a resolution opposing any parental consent or notification
    mandates that did not include provision for nonjudicial bypass.
    We thought it was far too onerous to require a teenager already
    undergoing the trauma of an unintended pregnancy to also have
    to face and navigate an intimidating judicial system.
        It was our view that any morally responsible notification
    or consent requirement had to allow young women to turn for
    help to a responsible adult other than a parent or a judge, to
    go instead to a grandparent or an aunt, a teacher, a neighbor,
    a counselor, minister, rabbi, a doctor.
        Our position encourages the very thing this bill would
    outlaw. Certainly, we want young people to be able to talk to
    their parents, but when they can't or won't, we want to make it
    easier not harder for them to turn to other responsible adults.
        And most certainly, we don't want to make it harder for
    their doctors to be their allies and advocates. We adopted this
    resolution by a large majority not because we don't care about
    parental notification and involvement, but because we know that
    no one can simply legislate healthy communication with
    families, and we know that of those girls who do not involve
    their parents, many feared violence or being thrown out of
    their home.
        There is no excuse good enough to justify legislation that
    further imperils young people who are already living in danger
    in their own homes. Teens deserve to be able to talk, to turn
    to their parents for love and support and guidance. But when
    they can't, we want them to turn to some responsible adult.
        Please don't outlaw the very help we want our children to
    have. Oppose this bill. Oppose it out of compassion for those
    young people who cannot for reasons of safety comply with its
    provisions.
        I am sure that each of your families is a loving and
    supportive one, and your daughter knows she can always turn to
    you for anything. But what about her best friend? What about
    your neighbor's daughter?
        Please don't leave any scared teenager alone and without
    help.
        Thank you for the opportunity to provide this testimony.
        [The prepared statement of Rev. Ragsdale follows:]

                                   __________
        Mr. Franks. Dr. New, I will recognize you now 5 minutes,
    sir.
        Just pull that microphone close. We are going to have to
    just start turning those on at the beginning of the hearing, I
    think, because they fool everybody always.
        Is it on now?

       TESTIMONY OF MICHAEL J. NEW, Ph.D., DEPARTMENT OF SOCIAL
               SCIENCES, UNIVERSITY OF MICHIGAN--DEARBORN

        Mr. New. Chairman Franks, distinguished guests, thank you.
    I appreciate this opportunity to offer testimony on behalf of
    the Child Interstate Abortion Notification Act. I am currently
    assistant professor of political science at the University of
    Michigan-Dearborn. I am also an adjunct scholar at the
    Charlotte Lozier Institute, the research and education arm of
    the Susan B. Anthony List here in Washington, D.C. I have a
    Ph.D. in political science and a master's degree in statistics,
    both from Stanford University.
        I have authored nine articles which have appeared in
    various peer-reviewed journals, three of which have been on the
    topic of State-level pro-life legislation. In March 2011, an
    article of mine on this topic was published in State Politics &
    Policy Quarterly, which is the top State politics journal in
    the country.
        I have evaluated the research on parental involvement laws
    that has appeared in peer-reviewed journals in public health,
    economics, and political science. I have come across 18 peer-
    reviewed studies in total.
        The peer-reviewed research on the impact of State-level
    parental involvement laws arrives at a great deal consensus
    about their effects.
        In my testimony this morning, I want to highlight the four
    most important findings.
        First, every peer-reviewed study I have seen, 16 in total,
    finds that State parental involvement laws reduce the in-State
    abortion rate for minors. This is true of studies that analyze
    time series cross-sectional data, allow for simultaneous
    analysis of multiple laws. It is also true of States that focus
    on the individual--on the impact of an individual State-level
    law.
        There have been separate studies analyzing the laws of six
    States, including Indiana, Massachusetts, Minnesota,
    Mississippi, Missouri, and Texas. The findings are all very
    similar. After the passage of a parental involvement law, the
    research shows a statistically significant reduction in the in-
    State minor abortion rate from anywhere from 13 percent to 42
    percent. Most of these find the decline somewhere between 15
    and 20 percent in the in-State minor abortion rate.
        My own research shows that those States which require both
    parents be involved, Minnesota, Mississippi, have seen even
    larger declines.
        Secondly, parental involvement laws are always worth
    enacting because the in-State decline in the abortion rate
    consistently exceeds any out-of-State increase. The two best
    studies in State-level parental involvement laws both show
    this.
        The first study looked at the Massachusetts law that took
    effect in 1981. That study appeared in the American Journal of
    Public Health.
        The second study analyzed the Texas law, which took effect
    in 2000. That study appeared in the New England Journal of
    Medicine in 2006.
        Both studies are unique because they analyze monthly data
    on in-State minor abortions, out-of-State minor abortions, and
    births to minors. Both studies found that after the enactment
    of both the Massachusetts law and the Texas law, the in-State
    minor abortion decline clearly exceeded the out-of-State
    increase.
        Furthermore, both studies did find evidence of short-term
    increases in the minor birthrate. The Texas study found that
    girls who are over 17-and-a-half-years-old are more likely to
    give birth. Another Texas study analyzing similar data showed
    the birthrate for 17-year-olds increased by 2 percent after the
    parental involvement law took place.
        The Massachusetts study suggested that in the year after
    the parental law took effect, 100 minors gave birth instead of
    having abortions as a result of law.
        Third, every State that tracks out-of-State abortions after
    a parental involvement law takes effect finds an increase in
    the number of girls who obtain abortions in adjacent States
    without parental involvement laws. Now, the number depends on
    the State. In large States like Texas, relatively few minor
    girls cross the State line to have an abortion. But in smaller
    States, like Massachusetts and Missouri, a much larger percent
    do. In fact, a fairly substantial decline--or, a fairly
    substantial percentage of the minor abortion rate decline in
    States like Massachusetts and Missouri is due to minor girls
    crossing State lines and having abortions in States where the
    laws are more permissive.
        The fourth and final point I would like to make is that the
    knowledge that parents will be involved with an abortion
    decision provides teen girls with a strong disincentive to
    engage in unprotected sexual activity. There is a very broad
    research, very body of research, I should say, on the positive
    public health of parental involvement laws.
        A 2003 study in the Journal of Health Economics found that
    parental involvement laws are reducing teen pregnancy rate
    anywhere from 4 to 9 percent. A 2008 study in the Journal of
    Law, Economics and Organization, found that parental
    involvement laws reduced the gonorrhea rate for minors from
    anywhere from 12 to 20 percent.
        Finally, this past February, the Journal of Economic
    Inquiry published a study which shows that the enactment of
    parental involvement law lowers the teen suicide rate for minor
    girls.
        As such, I would encourage Members of the Committee to
    support the Child Interstate Abortion Notification Act. It will
    give parents more involvement over how their minor daughters
    resolve pregnancies.
        I think it is safe to say that parents are more invested in
    the well-being of their minor daughter than a boyfriend, a
    friend, or a relative. They also have better knowledge of their
    daughter's medical history. There is evidence where minor girls
    obtained abortions without their parent's knowledge and died
    because they did not realize they were allergic to the
    anesthesia.
        Based on the testimony I have given, I am confident that
    the Child Interstate Abortion Notification Act will lead to
    fewer abortions and better public health outcomes for teen
    girls. Thank you.
        [The prepared statement of Mr. New follows:]

                                   __________

        Mr. Franks. Thank you, Dr. New.
        And thank all of you.
        Professor Collett, you know you heard some of the previous
    comments related to the constitutionality of the law. And I
    guess it is always a good thing to sometimes restate the
    obvious. Essentially, this bill says that one cannot circumvent
    parental consent laws in a State by, without the parent's
    knowledge, taking a minor girl across State lines for an
    abortion.
        Obviously, I have a little girl. She is only 3. But I hope
    that she doesn't run into somebody who would have the
    philosophy of Rev. Ragsdale.
        With that said, can you tell me--if you could kind of
    expand on your reasoning for why this is a constitutional law?
        Ms. Collett. Certainly. In fact, this bill is far narrower
    than the Free Access to Clinic Entrance Act, because it
    operates only on residents of the State when they leave their
    State. It applies the home State law, and simply facilitates
    the State's ability to protect minors consistent with that.
        There are numerous Supreme Court decisions that allow when
    there is interstate movement of persons related to commercial
    activity, that that interstate movement of persons can be
    constitutionally regulated by this Congress. For example, in
    the Caminetti case, the taking of women across State lines for
    immoral purposes, was upheld. Certainly the Raich case dealing
    with medical marijuana, the court upheld the congressional
    authority to involve itself in medical determinations.
        It is very clearly constitutional. This Congress has on
    numerous occasions relied upon the interstate commerce clause
    for its power. That is the enumerated power that, under this
    instance, it would be appropriate to uphold the statute under.
        Mr. Franks. Well, I always find it a little unnerving when
    people tell me that to say, you know, that someone taking a
    minor child of someone else's across the State lines to perform
    or have a surgery performed upon them, that somehow that it is
    unconstitutional to recognize parent's rights in that regard,
    it just astonishes me beyond comprehension.
        Dr. New, you testified that the academic research on
    parental involvement laws say that it has an impact on their
    in-State minor abortion rates, and I would like for you to
    expand on that.
        But you also say that there is a frequent crossing of State
    lines among minor girls where there is a proximity of a State
    that does not have these laws and where there are people that
    will actually take someone else's child across State lines to
    have a surgery performed on them that will take another child's
    life and endanger the first child's life.
        So would you say that your study in this area points to the
    conclusion that parental involvement laws are successful in
    reducing abortions but that there would be an even greater
    success in reducing abortions if Congress enacted a law
    prohibiting the transportation of minors across State lines to
    have abortion laws without the parent's knowledge or
    involvement?
        Mr. New. Yes. I think those are both fair statements. I
    mean, literally, every peer-reviewed study on this topic shows
    that when a State passes a parental involvement law, the in-
    State minor abortion rate goes down. There is a very broad
    consensus about that. Sixteen peer-reviewed studies in total
    that I have looked at, and they all arrive at the same
    conclusion.
        They also found, the studies can really track accurately
    both the in-State decline and compare it to the out-of-State
    increase. There are some States that have reciprocal reporting
    arrangements, where they know kind of what is happening to
    these minor girls, pretty much every study also finds--both
    studies that look at that do find the in-State decline exceeds
    the out-of-State decrease.
        So I think it is fair to say that these laws are effective.
    We also, again, do see a short-term increase in minor
    birthrates, meaning that once these laws are passed, some
    minors who otherwise had abortions decided to give birth.
        But I do think these laws would be made more effective if
    the Child Interstate Abortion Notification Act did take effect,
    because in many States, especially States with close proximity
    to other States with more permissive laws, you do see a
    substantial part of the in-State minor abortion decline due to
    the fact that minors cross State lines.
        That was certainly true in Massachusetts. When
    Massachusetts passed their law in 1981, it was surrounded by--
    basically every other State did not have a parental involvement
    law, including New York, including New Hampshire, including
    Rhode Island up until 1982, including Connecticut.
        And, again, a number of Massachusetts minors circumvented
    that law by getting abortions in other States.
        There was a study of the Missouri law that was enacted in
    1985, and it was again similar. Illinois does not have a
    parental involvement law, and there was evidence that many
    minors did go across the border and obtain abortions in
    Illinois.
        So I really do think that the Child Interstate Abortion
    Notification Act would really strengthen these parental
    involvement laws that are already doing a lot of good in the
    respective States.
        Mr. Franks. You know, I can't help but wonder how parents
    feel when they find that some stranger has taken their minor
    daughter across State lines for an abortion, so that they can
    keep it from their parents. I know how I would react. But I am
    wondering why that isn't something that is more obvious to
    everyone here.
        So I will now recognize Mr. Nadler for 5 minutes for
    questions.
        Mr. Nadler. Thank you, Mr. Chairman.
        Rev. Ragsdale, a moment ago the Chairman said he hoped his
    daughter never ran into someone like you or with your
    philosophy. Could you describe the kind of situations where
    another adult, either relative or perhaps a clergy person,
    might need to assist a young woman who is pregnant, where it
    would be in her welfare for that person to do so? And is a
    parent always the best person to have involvement in a
    situation, or is it even possible?
        Rev. Ragsdale. Well, Mr. Nadler, you actually referenced
    just such a situation in your opening remarks, where the father
    shot the daughter, who had hoped to get an abortion.
        A lot of young women seeking abortions were impregnated by
    their fathers, or they are in homes where the parents are
    sufficiently emotionally unstable that they may disrupt the
    entire family. Children are thrown out of their homes. They are
    beaten.
        One of the past times that I testified on this, I was still
    a parish priest. And a man in my parish with a teenage daughter
    said to me, ``I would be furious if you did that with my
    daughter.'' I said, ``Well, I wouldn't have to do that with
    your daughter. If she came to me because she was afraid to talk
    to you, I know that you are safe. I would take her, go with you
    her to talk to you and deal with this.''
        But there are young women who are in danger. They are in
    danger of being beaten. They are in danger of being killed.
    They are in danger of being thrown out of their homes.
        They have to find another way to get these procedures. And
    I don't want them doing it without any adult support, nor does
    the Episcopal Church.
        So that is why we support nonjudicial bypass provisions
    that would allow a grandparent, a teacher, a clergy person to
    accompany these young women and to keep them safe.
        Mr. Nadler. There has been a lot of talk recently that a
    requirement in law that insurance policies cover contraceptives
    is an assault on the religious liberty of those employers who
    don't want to pay insurance even if they don't have to pay
    extra, because it is against their religion to have people use
    contraceptives.
        Would this bill be an assault on your religious liberty or
    the religious liberty of the Episcopal Church in saying that
    what your ministry compels you to do would become a criminal
    act?
        Rev. Ragsdale. Yes.
        Mr. Nadler. In exactly the same way as it is alleged that
    the contraceptive requirement is an assault on the religious
    liberty of some other church?
        Rev. Ragsdale. Well, I am not sure in exactly the same way,
    because I don't concur that the contraceptive coverage is an
    assault on the religious liberty----
        Mr. Nadler. Well, I don't agree on that either, and I don't
    think this is an assault on religious liberty, but if that is,
    this is.
        Rev. Ragsdale. But I am not taking Federal money, and,
    therefore, to interfere with my ability to do my ministry is an
    assault.
        Mr. Nadler. Would be even worse.
        Rev. Ragsdale. And to fulfill the provisions that the
    Episcopal Church has passed in general convention many years
    ago.
        Mr. Nadler. Thank you.
        Let me ask you this. We heard, from 2005 through 2010, 559
    judicial bypasses were sought in the State of Idaho. During
    that time, a total of 24 were granted. In three of those years,
    none were granted at all.
        That is half a percent of young women who managed to find
    their way through the court system, who tried to do so. The
    records for the other States are no better. Many judges simply
    refuse to grant the bypass ever.
        Would you say the judicial bypass system is a sham in
    practice?
        Rev. Ragsdale. I would like to believe that there are some
    responsible, ethical judges who behave appropriately, and it is
    sort of in my business to believe things in contradiction to
    the evidence from time to time, but it certainly seems the
    evidence suggests that, yes, it is a sham.
        When the Episcopal Church suggested--insisted on
    nonjudicial bypass provisions, this was before we had this
    experience. We simply wanted it because we thought navigating
    the court system was just too much to ask, too intimidating to
    ask of a young woman already in a tricky situation.
        Having seen since the evidence of what actually happens in
    these judicial bypass procedures, it seems clear that they are
    ineffective at best and often abusive. And we really would not
    want to subject any person to those procedures as they are
    exercised in most States.
        Mr. Nadler. Thank you.
        Professor Collett, this bill only has an exception if an
    abortion is, ``necessary to save the life of the minor because
    her life was endangered by a physical disorder, physical
    injury, or physical illness, including a life-endangering
    physical condition caused by or arising from the pregnancy
    itself.''
        Does is exception comply with the constitutional mandate
    that you have to permit an abortion when necessary for the life
    or health of the mother? And to the extent that a woman might
    need a medical treatment that is inconsistent with pregnancy,
    she needs medical treatment that is inconsistent with
    pregnancy, but is not caused or arising from the pregnancy
    itself, wouldn't the Constitution require that an abortion be
    permitted in that case as well, contrary to this law, to this
    bill, rather?
        Ms. Collett. Congressman Nadler, in fact, I believe the
    constitutional case that you are relying on is Doe v. Bolton,
    which was a statutory construction case. It was not an
    interpretation of the Constitution. It was an interpretation of
    the----
        Mr. Nadler. Excuse me, there is not a constitutional
    requirement under applicable Supreme Court law that abortions
    be allowed for the life or health of the mother?
        Ms. Collett. I am sorry, Congressman Nadler. If I could
    complete my answer.
        In Doe v. Bolton, where they gave the life or health of the
    mother language, it was statutory construction. In Planned
    Parenthood v. Casey, which was an opinion that occurred 20
    years later, in fact, they upheld an emergency exception
    remarkably similar to this on a constitutional basis where the
    language did not have the health of the mother.
        In Ayotte v. Planned Parenthood of Northern New England,
    the most recent United States Supreme Court case dealing with
    parental involvement laws, the Court, in fact, even upheld the
    statute at issue in that case without an emergency exception.
        I believe this is completely constitutionally consistent
    with Planned Parenthood v. Casey and Ayotte.
        Mr. Nadler. So it is your belief that an abortion can be
    refused even if, constitutionally, even if refusing that
    abortion would wreck the health of the mother but wouldn't kill
    her?
        Ms. Collett. I believe the Court has upheld similar
    exceptions.
        Mr. Nadler. The answer is yes, you believe that that is the
    state of the law.
        Ms. Collett. I believe that is the state of the law.
        Mr. Nadler. Thank you. You are in a very small minority, I
    must tell you.
        Thank you. I yield back.
        Mr. Franks. All right, I would now yield to Mr. Jordan for
    5 minutes.
        Mr. Jordan. I thank the Chairman for the time and for this
    legislation, this hearing.
        Dr. New, the premise from Ms. Ragsdale is that if we have
    this law or, frankly, any parental notification, parental
    consent law, that there is the potential that minors can be
    harmed if they have to communicate with their parents.
        You cited a number of studies.
        Mr. New. Yes.
        Mr. Jordan. Do any of the studies show that that actually--
    you see an increase in harm to minors where you have States
    with parental notification, parental consent laws?
        Mr. New. I am not aware of any body of peer-reviewed
    research which shows an increase in child abuse rates that
    follow from the enactment of State-level parental involvement
    laws, so, no, I have yet to see a study that would show that.
        Mr. Jordan. So your answer is that not one single study
    shows that involving the people who care most about children,
    their parents, not one single study shows that there is an
    increase in child abuse? Is that accurate?
        Mr. New. I have researched the academic literature, and I
    think I have been fairly thorough. There may something out
    there I haven't seen, but I have been very thorough in my
    reading, and I have yet to come across one peer-reviewed study
    that----
        Mr. Jordan. Not one single study?
        Mr. New. No.
        Mr. Jordan. Okay.
        And, Professor Collett, do you know of any studies that
    show what the reverend asserts?
        Ms. Collett. In fact, there is a study to the contrary by
    Henshaw and Kost. Of course, Stanley Henshaw is a demographer
    of the Guttmacher Institute, a research affiliate of Planned
    Parenthood. The study is ``Parental Involvement in Minors'
    Abortion Decisions.'' It was published in 1992. Table 5 of that
    particular study, Congressman, in fact, indicates that although
    minors had initially, a small minority of minors, had expressed
    concerns that there would be violence or be thrown out of their
    home, and that is why they were reluctant to inform the
    parents, when researchers inquired after the fact, there was
    not a single study in which violence had occurred.
        Mr. Jordan. So, in fact, we don't have one study that shows
    that there is an increase in harm to young people, but we have
    research that shows it actually could be positive.
        Ms. Collett. There is no research that shows harm.
        Mr. Jordan. Okay.
        Reverend, let me ask you a slightly different question.
    There was an article recently published in the Journal of
    Medical Ethics, two bioethicists/philosophers argued for what
    they term after-birth abortion. And they assert, and I quote,
    ``We claim that killing a newborn could be ethically
    permissible in all circumstances where abortion would be.''
        And I want to know, first, if you are familiar with the
    article; and, second, if you agree with the assertion of these
    two bioethicists/philosophers.
        Rev. Ragsdale. I am not familiar with that particular
    article. I am certainly familiar with philosophers who have
    made similar arguments. It is sort of the job of academic
    philosophers to think way outside the box.
        We, obviously, utterly disagree and don't consider it a
    responsible position.
        Mr. Jordan. Okay. And what would you call the term after-
    birth abortion? Is there a better definition, better language
    for that?
        Rev. Ragsdale. I am sorry, I don't think there is any such
    thing as after-birth abortion. Abortion is the termination of--
    --
        Mr. Jordan. Yes, it seems to me this is infanticide. It is
    murder. It is the taking of innocent human life.
        Mr. Nadler. Would the gentleman yield for a moment?
        Mr. Jordan. These ethicists seem to----
        Mr. Nadler. I think I can help clear this up. Will the
    gentleman yield for a moment?
        Mr. Jordan. I would be happy to yield.
        Mr. Nadler. I think just about everyone on this side of the
    aisle and on that side of the aisle voted for the--what was
    that called?--the Born Alive Infants Protection Act, which was
    on this issue. I stated at the time that this was absurd, that
    this was infanticide and murder, and we all voted for it, and
    stated at the time that it was unnecessary because it was
    already the law in every State that it was murder.
        Mr. Jordan. And I appreciate that, but we have a journal
    printing this kind of ridiculous----
        Mr. Nadler. There is always some nut out there.
        Mr. Jordan. Yeah. My question was to the reverend, and she
    answered the question.
        Rev. Ragsdale. One of the repercussions of the tenure
    system. You are encouraged and entitled to think any bizarre
    thing you want and to publish it, and it pushes the envelope.
        Mr. Jordan. Well, that is good to hear.
        Mr. Chairman, with that, I would yield back.
        Mr. Franks. Well, thank you, Mr. Jordan.
        It is kind of ironic that, you know, that we have talked
    about--at least we have some agreement here that after-birth
    abortion is murder, and yet somehow there is some argument that
    10 minutes earlier before you travel 5 inches down a birth
    canal, that all of a sudden everything is changed.
        And it is also interesting that our President voted twice
    against the legislation that would have protected children born
    alive in his legislative career.
        With that, I would yield to Mr. Quigley for 5 minutes for
    questions.
        Mr. Quigley. Thank you, Mr. Chairman.
        Mr. Chairman, I think anyone watching these hearings or the
    hearing, since I have been here for 3 years now, understands
    how just extraordinarily emotional and how powerful they are,
    how strong people's feelings are, how difficult the decisions
    that have to be made are.
        And for me, what that seems to bring out is the fact that,
    sitting here in Washington, I have absolutely no right to tell
    people how they handle that decision. It is impossible for us
    to know all of the scenarios that exist under those
    circumstances, all of the risk, all of the dangers, all of the
    emotional turmoil that takes place. And for us to put ourselves
    in that place is inappropriate, especially for those who claim
    that government's role is least, that government shouldn't
    intrude on people's lives.
        So I appreciate that nothing we say here ever, if I am here
    3 years more or 30 years more, will ever change anyone else's
    mind. But I will say this, however any of us feel, it is worse
    and it is wrong for us to place ourselves above anybody's
    decision-making process, especially when it comes to something
    as serious as this.
        But I will ask the reverend one question.
        Are you aware what major medical groups have said or talked
    about in terms of confidentiality in medical care for minors?
        Rev. Ragsdale. I believe virtually every medical group that
    one can name is on the record as opposing this sort of
    regulation, because of their interest in protecting the doctor-
    patient relationship and not wanting to pit doctors against the
    young women who come to them for help.
        Mr. Quigley. And, well, the scenarios that you have seen,
    and for what you know, how would you imagine that this measure
    would actually, in reality, be enforced? Border patrols or
    questions or putting doctors in a very unique position?
        Rev. Ragsdale. I think the goal is to have a chilling
    effect on doctors and make them unwilling to perform abortions.
        It is interesting that the success of these parental
    notification requirements is being measured by Dr. New as
    reducing abortions, which suggests to me that their point here
    is not actually protecting young women's health but reducing
    abortions, which is a constitutionally protected right.
        So I think the goal is to have a chilling effect on
    doctors, to deny young women the adult support that they might
    need to move forward safely with this procedure. And I think
    the result will be, and I think the result has been, and
    perhaps the reason that the statistics don't show abuse is that
    the young women are not foregoing abortions, the ones who are
    in danger, so much so they are getting them illegally or
    without any adult support.
        Mr. Quigley. Right, and I think it teaches us that there is
    a difference between correlation and causation.
        Rev. Ragsdale. Well, exactly.
        Mr. Quigley. And there is also a difference that wasn't
    taken into consideration of where the abortions are actually
    taking place. It is not taking place in the same State for the
    reasons we were talking about before.
        Thank you, and I yield back, Mr. Chairman.
        Mr. Franks. I thank the gentleman. I have to thank him for
    his tone, but placing himself above someone else's decision, he
    mentioned that, and that is one of the challenges with this
    legislation, we are trying to make sure that perfect strangers
    don't place themselves above a parent's right to decide things
    over their own children. The judges, obviously, you testified
    that they have some reticence to do so, but a perfect stranger
    who finds the arrogance to do that is just astonishing to me.
        And you are right, too, Mr. Quigley. There are intense
    feelings about this. There were intense feelings when we were
    debating the issue of slavery, when the Supreme Court said
    slaves weren't persons. But people's minds did change, finally.
    They did change.
        Mr. King, I would recognize you for 5 minutes, sir.
        Mr. King. Thank you, Mr. Chairman.
        And again, I thank the witnesses for your testimony, and
    this raises a number of questions in my mind as I listened to
    their response.
        I would turn first Professor Collett.
        Would you assert that there existed a conscience protection
    for medical practitioners prior to the passage of Obama care?
        Ms. Collett. Well, certainly, there is the Weldon act and
    the Hill-Burton Act that protected both medical institutions as
    well as individual practitioners in certain instances.
        Mr. King. And is it also your understanding that the
    passage of the Patient Protection and Affordable Health Care
    Act has struck that language of conscience protection and
    allowed for an executive branch to, essentially, impose
    obligations on health care practitioners that go beyond that
    conscience protection that you cited?
        Ms. Collett. Actually, Congressman, I believe that is an
    issue that is being litigated as we speak on behalf of a number
    of both individuals and religiously affiliated institutions. I
    do believe that they will be successful in their litigation,
    because I do not believe that the Secretary of Health's
    regulation will withstand constitutional scrutiny.
        Mr. King. Thank you.
        And I turn to Rev. Katherine Hancock Ragsdale and ask if
    you agree with, at least philosophically, with conscience
    protection for medical practitioners?
        Rev. Ragsdale. No.
        Mr. King. You think they should be compelled, then, to
    provide sterilization, abortifacients, and contraceptives even
    if they object to it on religious terms?
        Rev. Ragsdale. You know, I am a church person. I believe in
    conscience. We are big supporters of conscience. We believe
    that everyone's conscience should be respected as long as they
    pay the price for it.
        Civil disobedience, if you are willing to pay the price for
    it. Conscientious objection, if you are willing to pay the
    price for it.
        But if you are not willing to shoot people, don't join the
    Army. If you are not willing to carry a gun at all, don't
    become a police officer. If you are not willing to experiment
    on animals, medical research probably is not the place for you.
    If you are not willing to provide full medical care, don't go
    into----
        Mr. King. I am sorry, the clock is ticking, so I do get
    your point.
        And let me then ask the question, if this conscience
    protection then apparently, if you are willing to pay the
    price, so in your testimony you talk about assisting a young
    lady and you state that you don't believe that you violated any
    laws. But you also assert, if I note this testimony, that you
    have you have no choice because of your oath and your
    commitment. You say, I have no choice even if you tell me it is
    a crime to exercise my ministry, I will have no choice. And I
    assure you I am not alone.
        So are you saying to this Congress, then, that if this
    legislation passes and you are met with the same or a similar
    question for an individual that you described in this
    testimony, that you would cross the State line, you would
    violate Federal law, you would be willing to go to jail for a
    year or pay a $100,000 fine, if you believe it violated your
    conscience to fail to serve?
        Rev. Ragsdale. I hope to God that I would have the courage
    of my convictions and my faith to do that.
        Mr. King. Do you believe that a judge should have a
    conscience protection?
        Rev. Ragsdale. I beg your pardon?
        Mr. King. Do you believe that a judge should have----
        Rev. Ragsdale. That a judge should not have to uphold the
    law if he disagrees with it?
        Mr. King. I mean, just to suspend this for a second, I
    would like to turn to Professor Collett, and then I will come
    back to you on this.
        Professor Collett, I will tell the narrative here, and that
    is that the parental notification law that was passed in Iowa,
    I was part of, that the gentleman, Mr. Nadler, discussed. And I
    met with judges around the State, and I can think one in
    particular who expressed to me how troubled he was that the law
    required him to provide for the judicial waiver, the judicial
    bypass, I think as it was referred to. And he was greatly
    troubled because of his faith, because of his convictions.
        But he found himself, a sworn judge, required to carry out
    the law. And now, because of the language in the law, he was
    required to provide that judicial bypass even though it
    violated his most profound moral and religious convictions.
        Do you believe judges should have conscience protection?
        Ms. Collett. Congressman, this actually came up on the
    Texas subadvisory committee on drafting court rules for
    parental notification and parental consent in that State. At
    that time, we determined it was appropriate for a judge to
    recuse, as they can on any matter where they believe their
    personal values will not allow them to render a judgment under
    law.
        Mr. King. And, Reverend, is it your position that not to
    recuse or to apply the same philosophy to the judges as you
    would the medical practitioners, either pay the price or leave
    the profession and find something else to do?
        Rev. Ragsdale. Well, you understand I am not a legal
    expert. Recusal sounds like a reasonable alternative to me, but
    I haven't given this a lot of thought.
        Mr. King. But if you would allow a judge to recuse himself,
    wouldn't you allow a medical practitioner to recuse himself as
    well?
        Rev. Ragsdale. Medical practitioners have a responsibility
    to respond to the emergencies in front of them. If there is
    another doctor handy that you can hand off to, that is fine. If
    not, it is your job to provide medical care.
        Mr. King. Thank you. There are very few pregnancies that
    are emergencies.
        I yield back.
        Mr. Franks. Thank you, Mr. King.
        I now recognize Mr. Scott for 5 minutes.
        Mr. Scott. Thank you, Mr. Chairman. I think a lot of the
    questions I have have been answered. I just have a couple of
    technical questions.
        Professor Collett, in the phrase ``knowingly transports,''
    would that include a taxicab driver who, a young lady hops in
    the cab and says take me to the abortion clinic; I need an
    abortion.
        Would they be guilty of violating this code section?
        Ms. Collett. Congressman, I don't believe so, because it
    also requires with the intention to assist her in obtaining the
    abortion.
        Mr. Scott. Taking them to the abortion clinic is not
    assisting?
        Ms. Collett. It is not with the intention of assisting her
    in doing that.
        Mr. Scott. Okay, knowingly transport, does that include
    someone who hops in the taxicab with the pregnant teenager?
        Ms. Collett. Have they hopped in the taxicab with the
    intention of helping her evade the State's parental involvement
    law?
        Mr. Scott. The question is transports.
        Ms. Collett. I understand, Congressman. Because this has
    criminal sanctions, it will be strictly construed under
    constitutional standards, and, therefore, you have to meet all
    elements.
        Mr. Scott. So if it is strictly--you are not transporting;
    you are just accompanying. Is that the same thing?
        Ms. Collett. Again, it depends on the intention.
        Mr. Scott. The mens rea is just on the intent to get an
    abortion, not the mens rea to evade the parental consent; is
    that right?
        Ms. Collett. Crossing State lines, that is correct.
        Mr. Scott. The law exempts parents from the application.
    Does it exempt a sister?
        Ms. Collett. No, not on the face of the statute.
        Mr. Scott. So the sister accompanying a pregnant sister
    would violate criminal law by accompanying her sister to the
    abortion clinic?
        Ms. Collett. Unless the law that is to be applied, the law
    of the minor's residence, includes siblings. There are a couple
    States that do.
        Mr. Scott. I am sorry. Where is it exempt from this law?
        Ms. Collett. The requirement is that they apply the law of
    the minor's residence. And, therefore, if the law of the
    minor's residence allows another adult relative to accompany
    the minor, they would not be a violation of the law----
        Mr. Scott. But in absence of that, the sister would be
    violating Federal law.
        Ms. Collett. That would be correct.
        Mr. Scott. Okay, if a college student who lived in a State,
    was a resident of a State, without parental consent law, went
    to college in a State without a parental consent law, and
    sought an abortion, why does this law require a 24-hour
    parental consent?
        Ms. Collett. The law does not use college attendance as a
    standard. Under that standard, there would be numerous adults
    that would be subject to the involvement of someone else. This
    law deals with adults only.
        Mr. Scott. The college wasn't--if you are in another State
    without a parental consent law for any reason, say college,
    your home State does not have a parental consent law, you are
    performing the abortion in a State that is not the residence of
    the teenager. This law requires a 24-hour notice,
    notwithstanding the fact that neither State has a parental
    consent law; is that right?
        Ms. Collett. I am sorry, Congressman. Could you direct me
    to the provision. I am confused by your----
        Mr. Scott. Page 7, line 15.
        Ms. Collett. I am sorry, I will need the section, because I
    don't have your printing.
        Mr. Scott. Section 3, Child Interstate Abortion
    Notification, and it says offense generally, number two,
    parental notification, if a physician who performs or endorses
    an abortion on a minor who is a resident of a State other than
    the State in which the abortion is performed must provide or
    cause to provide 24-hour actual notice to parents.
        Ms. Collett. The numbering is different that I printed off
    of Thomas, but I see where you are now. I am sorry.
        Yes, it does.
        Mr. Scott. So there is no parental consent law in the State
    in which abortion is being performed, no parental consent law
    in the teenager's home residence, and yet Federal law is
    requiring a parental notice.
        Ms. Collett. On a minor who is a resident of a State other
    than State in which the abortion is being performed, yes.
        Mr. Scott. Okay. And is there any judicial bypass in that?
        There can't be any judicial bypass, because you don't have
    a system in either State; is that right?
        Ms. Collett. It does not appear to be the case, although
    most States have emancipation laws, so you can get an order of
    partial emancipation. That is done in numerous States.
        There are at least two States that have parental
    involvement laws that have no judicial bypass in them.
        Mr. Scott. Rev. Ragsdale, can you explain whether it is
    better or worse for a teenager to be accompanied when they go
    to get an abortion?
        Rev. Ragsdale. Accompanied by an adult? Yes, we want
    teenagers to have support, adult support, preferably from their
    parents. When that is not safe or not possible, we would like
    them to have other adult support. To ask a teenager to undergo
    any significant decision, and any medical procedure without
    adult support, seems to us uncharitable and unwise.
        Mr. Franks. We appreciate the witnesses here. We appreciate
    your time today.
        I always think it is important sometimes just to restate.
    This bill essentially says that someone cannot arrogate unto
    themselves the parent's role of taking a minor girl across
    State lines for an abortion without the parent's knowledge. I
    am not even sure why we debate that sometimes. It doesn't seem
    like we have come very far at times.
        But in any case, I thank the witnesses.
        And without objection, all Members will have 5 legislative
    days to submit to the Chair additional written questions for
    the witnesses, which we will forward and ask the witnesses to
    respond as promptly as they can so that the answers may be made
    part of the record.
        Without objection, all Members will have 5 legislative days
    with which to submit any additional materials for inclusion in
    the record.
        And with that, again, I thank the witnesses. I thank the
    Members and observers.
        And this hearing is now adjourned.
        [Whereupon, at 10:43 a.m., the Subcommittee was adjourned.]
                                A P P E N D I X

                                  ----------

                   Material Submitted for the Hearing Record

     Prepared Statement of the Honorable Trent Franks, a Representative in
     Congress from the State of Arizona, and Chairman, Subcommittee on the
                                  Constitution
        The Child Interstate Abortion Notification Act, more
    commonly known as ``CIANA,'' is a modest measure to prevent the
    transportation of a minor across state lines to avoid parental
    consent laws that apply to abortion procedures. This law is
    consistently supported by approximately 70% of the American
    people in national opinion polls.
        More than 30 states have made it clear through legislation
    that parents have the right to know whether their daughters are
    trying to undergo abortions. Parents play a critical role in
    the well-being of their daughters, particularly in the abortion
    context. I quote the bill's sponsor, Ms. Ros-Lehtinen: ``As
    mother and a grandmother, I understand the importance of the
    unconditional love and support that parents can give to their
    children. This responsibility is non-negotiable and non-
    transferable. This bill assures young women that they are not
    alone if they ever find themselves contemplating undergoing an
    abortion.'' (unquote)
        Parental notification laws have proven to be effective at
    lowering the abortion rate among minors, and therefore they are
    effective at lowering the attendant risks that accompany
    abortion. Abortion is a serious surgical procedure, with
    physical and psychological risks, some of which can be
    especially detrimental when experienced at a young age. These
    include increased risk of breast cancer, extremely pre-term
    birth in subsequent pregnancy (that is, delivering at 28 weeks
    gestation or less), and suicide.
        Where a woman experiences an abortion early in life, she
    can lose the protective effect against breast cancer that a
    full term pregnancy provides with the inherent changes in
    breast tissue. Many developed countries legalized abortion in
    the early 1970s, and breast cancer rates have increased as much
    as 80% since the 1970s in these same countries.
        Likewise, where a woman has one induced abortion, she is
    50% -70% more likely to experience an ``extremely pre-term
    birth'' (delivery at 28 weeks or earlier) when she later
    attempts to carry a wanted child to term. This could be due to
    damage to the cervix during abortion, rendering it less
    competent. Where a woman has two abortions, she is 160% more
    likely to have an extremely pre-term birth.
        An extremely pre-term birth carries greatly increased risks
    for many serious health issues. For example, babies who are
    extremely pre-term have 38 times the risk of cerebral palsy
    than babies born full-term, in addition to increased risk for
    autism and mental retardation. Note that abortionists perform
    abortions on black women at approximately five times the rate
    of white women, and black babies therefore have four times the
    risk of extremely pre-term birth. Also note that the danger of
    subsequent premature birth is greater where the abortive woman
    is a girl under seventeen years of age. Premature birth rates
    are up greater than 43% since Roe v. Wade became law. Forty-
    nine studies worldwide confirm the abortion/premature birth
    causal link.
        Next, abortion and youth suicide are correlated. A study by
    two economists appearing in the January 18, 2012 online version
    of the Journal of Economic Inquiry shows that parental
    involvement laws are correlated with a decrease the incidence
    of teen suicide. ``The adoption of a law requiring a parent's
    notification or consent before a minor can obtain an abortion
    is associated with an 11%-21% reduction in the number of 15-
    through 17-year-old females who commit suicide.''
        We must enable parents to protect their daughters from an
    invasive surgical procedure that has significant, and sometimes
    deadly hidden costs.

          Prepared Statement of the Honorable Ileana Ros-Lehtinen, a
              Representative in Congress from the State of Florida
        I would like to thank the House Constitution Subcommittee
    for holding this hearing. The Child Interstate Abortion
    Notification Act (CIANA) is an important bill and I am pleased
    it is receiving the serious consideration it deserves. CIANA
    deals not only with abortion, but also with parental rights.
    This bill would make it a federal offense to knowingly
    transport a minor across state lines with the purpose of
    obtaining an abortion and circumventing the parental consent
    and/or notification laws of the minor's home state. It would
    prohibit doctors from performing abortions on out of state
    minors without obtaining parental consent for the procedure.
    This requirement would apply to all out of state abortions.
    Physicians would be exempted from these requirements if the
    minor has a judicial bypass from their home state, the minor
    claims to have been abused by a parent and the doctor informs
    state authorities or if the minor's life is immediately
    endangered by the continuation of the pregnancy.
        Parents are entitled to the right of being involved in
    their child's life. Responsibility to guide and direct their
    children's development belongs to the parents. This
    responsibility is non-negotiable and non-transferable.
    Currently, minors cannot get a tattoo without parental consent.
    Children cannot even take aspirins for headaches at their
    school without prior authorization from parents. However, that
    same minor can be taken across state lines to obtain an
    abortion without so much as a phone call to her mother or
    father. This is unacceptable and fundamentally corrosive to the
    institution of the family. More than 30 states have passed laws
    that require either parental notification and/or consent before
    a minor can undergo an abortion procedure. Moreover, in poll
    after poll a majority of the American people have made it clear
    that parents should be involved if their minor daughter is
    considering terminating her pregnancy. As mother and a
    grandmother, I understand the importance of the unconditional
    love and support that parents can give to their children. This
    bill assures young women that they are not alone if they ever
    find themselves contemplating undergoing an abortion. Having
    this right ripped away by individuals seeking to confuse, and
    at times even coerce, minors is criminal and the federal
    government must recognize it as such. Predatory and bullying
    tactics by a former boyfriend, or his parents, have led to
    young women being rushed into a decision they ultimately would
    not have chosen if allowed the chance to reflect and consult
    with their families.
        As a pro-life advocate, I believe that innocent life is
    sacred and unique. The precious gift of life is something that
    the unborn are entitled to through their inherent dignity as
    human beings. Congress has had the courage and wisdom to ensure
    this basic precept. Through legislation prohibiting the use of
    federal funds for abortions this body has unequivocally stood
    by the rights of the unborn. CIANA aims to resolve a gaping
    hole in Congress' long tradition of supporting pro-life issues.
        This legislation is neither radical nor draconian. On the
    contrary, this legislation is borne out of common sense and
    affirming our commitment to the unborn and to the rights of
    parents everywhere. Once again, I thank the House Constitution
    Subcommittee for convening this hearing and I look forward to
    working with my congressional colleagues as we move forward on
    consideration of this important legislation.

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