[House Hearing, 116 Congress]
[From the U.S. Government Publishing Office]


                   PROTECTING WOMEN'S ACCESS TO 
                      REPRODUCTIVE HEALTHCARE

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

                                HEARING

                               BEFORE THE

                         SUBCOMMITTEE ON HEALTH

                                 OF THE

                    COMMITTEE ON ENERGY AND COMMERCE
                        HOUSE OF REPRESENTATIVES

                     ONE HUNDRED SIXTEENTH CONGRESS

                             SECOND SESSION

                               __________

                           FEBRUARY 12, 2020

                               __________

                           Serial No. 116-100
                           
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]                           


      Printed for the use of the Committee on Energy and Commerce

                   govinfo.gov/committee/house-energy
                        energycommerce.house.gov
                        
                                 __________

                     U.S. GOVERNMENT PUBLISHING OFFICE
51-561 PDF                  WASHINGTON: 2023
___________________________________________________________________________       
 
                    COMMITTEE ON ENERGY AND COMMERCE

                     FRANK PALLONE, Jr., New Jersey
                                 Chairman
BOBBY L. RUSH, Illinois              GREG WALDEN, Oregon
ANNA G. ESHOO, California              Ranking Member
ELIOT L. ENGEL, New York             FRED UPTON, Michigan
DIANA DeGETTE, Colorado              JOHN SHIMKUS, Illinois
MIKE DOYLE, Pennsylvania             MICHAEL C. BURGESS, Texas
JAN SCHAKOWSKY, Illinois             STEVE SCALISE, Louisiana
G. K. BUTTERFIELD, North Carolina    ROBERT E. LATTA, Ohio
DORIS O. MATSUI, California          CATHY McMORRIS RODGERS, Washington
KATHY CASTOR, Florida                BRETT GUTHRIE, Kentucky
JOHN P. SARBANES, Maryland           PETE OLSON, Texas
JERRY McNERNEY, California           DAVID B. McKINLEY, West Virginia
PETER WELCH, Vermont                 ADAM KINZINGER, Illinois
BEN RAY LUJAN, New Mexico            H. MORGAN GRIFFITH, Virginia
PAUL TONKO, New York                 GUS M. BILIRAKIS, Florida
YVETTE D. CLARKE, New York, Vice     BILL JOHNSON, Ohio
    Chair                            BILLY LONG, Missouri
DAVID LOEBSACK, Iowa                 LARRY BUCSHON, Indiana
KURT SCHRADER, Oregon                BILL FLORES, Texas
JOSEPH P. KENNEDY III,               SUSAN W. BROOKS, Indiana
    Massachusetts                    MARKWAYNE MULLIN, Oklahoma
TONY CARDENAS, California            RICHARD HUDSON, North Carolina
RAUL RUIZ, California                TIM WALBERG, Michigan
SCOTT H. PETERS, California          EARL L. ``BUDDY'' CARTER, Georgia
DEBBIE DINGELL, Michigan             JEFF DUNCAN, South Carolina
MARC A. VEASEY, Texas                GREG GIANFORTE, Montana
ANN M. KUSTER, New Hampshire
ROBIN L. KELLY, Illinois
NANETTE DIAZ BARRAGAN, California
A. DONALD McEACHIN, Virginia
LISA BLUNT ROCHESTER, Delaware
DARREN SOTO, Florida
TOM O'HALLERAN, Arizona
                                 ------                                

                           Professional Staff

                   JEFFREY C. CARROLL, Staff Director
                TIFFANY GUARASCIO, Deputy Staff Director
                MIKE BLOOMQUIST, Minority Staff Director
                         Subcommittee on Health

                       ANNA G. ESHOO, California
                                Chairwoman
ELIOT L. ENGEL, New York             MICHAEL C. BURGESS, Texas
G. K. BUTTERFIELD, North Carolina,     Ranking Member
    Vice Chair                       FRED UPTON, Michigan
DORIS O. MATSUI, California          JOHN SHIMKUS, Illinois
KATHY CASTOR, Florida                BRETT GUTHRIE, Kentucky
JOHN P. SARBANES, Maryland           H. MORGAN GRIFFITH, Virginia
BEN RAY LUJAN, New Mexico            GUS M. BILIRAKIS, Florida
KURT SCHRADER, Oregon                BILLY LONG, Missouri
JOSEPH P. KENNEDY III,               LARRY BUCSHON, Indiana
    Massachusetts                    SUSAN W. BROOKS, Indiana
TONY CARDENAS, California            MARKWAYNE MULLIN, Oklahoma
PETER WELCH, Vermont                 RICHARD HUDSON, North Carolina
RAUL RUIZ, California                EARL L. ``BUDDY'' CARTER, Georgia
DEBBIE DINGELL, Michigan             GREG GIANFORTE, Montana
ANN M. KUSTER, New Hampshire         GREG WALDEN, Oregon (ex officio)
ROBIN L. KELLY, Illinois
NANETTE DIAZ BARRAGAN, California
LISA BLUNT ROCHESTER, Delaware
BOBBY L. RUSH, Illinois
FRANK PALLONE, Jr., New Jersey (ex 
    officio)
                            C O N T E N T S

                              ----------                              
                                                                   Page
Hon. Anna G. Eshoo, a Representative in Congress from the State 
  of California, opening statement...............................     2
    Prepared statement...........................................     3
Hon. Michael C. Burgess, a Representative in Congress from the 
  State of Texas, opening statement..............................     4
    Prepared statement...........................................     5
Hon. Frank Pallone, Jr., a Representative in Congress from the 
  State of New Jersey, opening statement.........................     6
    Prepared statement...........................................     8
Hon. Greg Walden, a Representative in Congress from the State of 
  Oregon, opening statement......................................     9
    Prepared statement...........................................    10

                               Witnesses

Yashica Robinson, M. D., Alabama Women's Center for Reproductive 
  Alternatives...................................................    12
    Prepared statement...........................................    15
    Answers to submitted questions...............................   284
Georgette Forney, President of Anglicans for Life, Co-Founder of 
  the Silent No More Awareness Campaign..........................    18
    Prepared statement...........................................    20
    Answers to submitted questions \1\
Teresa Stanton Collett, J. D., Professor of Law..................    34
    Prepared statement...........................................    36
    Answers to submitted questions...............................   287
Nancy Northup, President and CEO, Center for Reproductive Rights.    50
    Prepared statement...........................................    52
    Answers to submitted questions...............................   293
Holly Alvarado, Advocate.........................................    63
    Prepared statement...........................................    66

                           Submitted Material

H. R. 2975, the Women's Health Protection Act of 2019 \2\
Letter from Elizabeth Gillette, to Mr. Walden, Submitted by Mr. 
  Walden.........................................................   123
Letter of February 10, 2020, by Edith Ugarte, Abortion Silent No 
  More Awareness Campaign, Tell Your Story, submitted by Mr. 
  Bilirakis \3\

----------
\1\ Mr. Forney did not answer the submitted questions for the 
  record by the time of publication.
\2\ The information has been retained in committee files and also 
  is available at https://docs.house.gov/meetings/IF/IF14/
  20200212/110504/BILLS-1162975ih.pdf.
\3\ The information has been retained in committee files and also 
  is available at https://docs.house.gov/meetings/IF/IF14/
  20200212/110504/HHRG-116-IF14-20200212-SD003.pdf.
Letter from Carolina Pregnancy Center, submitted by Mr. Duncan...   125
Letter of February 12, 2020, to Ms. Eshoo, et al., from the 
  American College of Obstetricians and Gynecologists, submitted 
  by Ms. Eshoo...................................................   130
Letter of February 11, 2020, to Mr. Pallone, et al., from the 
  Reproductive Justice Community, submitted by Mr. Eshoo.........   141
Letter of February 12, 2020, to Ms. Eshoo and Mr. Burgess, by 
  Heather D. Boonstra, Vice President for Public Policy, 
  Guttmacher Institute, submitted by Ms. Eshoo...................   146
Report ``The Safety and Quality of Abortion Care in the United 
  States 2018, from the National Academies Press,'' submitted by 
  Ms. Eshoo \4\
Research of January 2020,``The Economic Consequences of Being 
  Denied an Abortion,'' by Sarah Miller, et al., from the 
  National Bureau of Economic Research, submitted by Ms. Eshoo 
  \5\
Research ``Socioeconomic Outcomes of Women Who Receive and Women 
  Who are Denied Wanted Abortions in the United States,'' by 
  Diana Greene Foster, Ph.D, et al., submitted by Ms. Eshoo......   152
 Research ``Women's Mental Health and Well-being Five Years After 
  Receiving or Being Denied an Abortion a Prospective, 
  Longitudinal Cohort Study,'' from JAMA Psychiatry, submitted by 
  Ms. Eshoo......................................................   159
Research ``Identifying National Availability of Abortion Care and 
  Distance from Major US Cities: Systematic Online Search,'' by 
  Alice F Cartwright, et al., Journal of Medical, submitted by 
  Ms. Eshoo......................................................   169
Report ``Roe and Intersectional Liberty Doctrine,'' Center for 
  Reproductive Rights, submitted by Ms. Eshoo \6\
Amici Brief of June, Medical Services v. Dr. Rebekah Gee, Supreme 
  Court Civil Action No. 18-1 3 and 18-1460, submitted by Ms. 
  Eshoo \7\
Report ``Evaluating Priorities, Measuring Women's and Children's 
  Health and Well-being against Abortion Restrictions in the 
  States Volume II,'' Center for Reproductive Rights, submitted 
  by Ms. Eshoo \8\
Statement of February 12, 2020, by Ronald Newman, National 
  Political Director and Georgeanne M. Usova, Senior Legislative 
  Counsel, from American Civil Liberties Union, submitted by Ms. 
  Eshoo..........................................................   182
Letter of February 12, 2020, to Mr. Pallone, et al., from LGBTQ, 
  submitted by Ms. Eshoo.........................................   190
Letter from Hope Clinic for Women, to Mr. Pallone, et al., 
  submitted by Ms. Eshoo.........................................   195


----------
\4\ The information has been retained in committee files and also 
  is available at https://docs.house.gov/meetings/IF/IF14/
  20200212/110504/HHRG-116-IF14-20200212-SD006.pdf.
\5\ The information has been retained in committee files and also 
  is available at https://docs.house.gov/meetings/IF/IF14/
  20200212/110504/HHRG-116-IF14-20200212-SD040.pdf.
\6\ The information has been retained in committee files and also 
  is available at https://docs.house.gov/meetings/IF/IF14/
  20200212/110504/HHRG-116-IF14-20200212-SD024.pdf.
\7\ The information has been retained in committee files and also 
  is available at https://docs.house.gov/meetings/IF/IF14/
  20200212/110504/HHRG-116-IF14-20200212-SD022.pdf.
\8\ The information has been retained in committee files and also 
  is available at https://docs.house.gov/meetings/IF/IF14/
  20200212/110504/HHRG-116-IF14-20200212-SD015.pdf.
Statement of February 11, 2020, ``Making change happen since 
  1893,'' by Beatrice Kahn, President and Sheila Katz, Chief 
  Executive Officer, National Council of Jewish Women, submitted 
  by Ms. Eshoo...................................................   198
Letter of February 10, 2020, to Mr. Pallone, et al., by Clare 
  Coleman, President and CEO, National Family Planning and 
  Reproductive Health Association, submitted by Ms. Eshoo........   200
Letter of February 11, 2020, to Mr. Pallone, et al., from 
  Platform, submitted by Ms. Eshoo...............................   202
Letter of January 29, 2020, to Mr. Blumenthal, et al., from 
  Independent Abortion Care Providers, submitted by Ms. Eshoo....   204
 Report ``What if Roe Fell 2019,'' Center for Reproductive 
  Rights, submitted by Ms. Eshoo \9\
Report of February 11, 2020,``The Women's Health Protection Act 
  of 2019--Ten Things You Need to Know About H.R. 2975,'' by 
  Thomas M. Messner, J.D., Charlotte Lozier Institute, submitted 
  by Ms. Eshoo \10\
Letter of February 11, 2019, to Mr. Pallone, et al., from the 
  Faith-Based, Religious, and Civil Rights Organizations, 
  submitted by Ms. Eshoo.........................................   206
Letter of February 12, 2020, to Ms. Eshoo, et al., by Judy Chu, 
  et al., submitted by Ms. Eshoo.................................   211
Letter of February 12, 2020, to Ms. Eshoo, et al., by Kristen 
  Clarke, President and Executive Director, Lawyers' Committee 
  for Civil Rights Under Law, submitted by Ms. Eshoo.............   213
Letter of February 12, 2020, to Ms. Eshoo, by Toni Van Pelt, 
  President, National Organization for Women, submitted by Ms. 
  Eshoo..........................................................   221
Letter to Energy and Commerce Committee Members, by S. Nadia 
  Hussain, Maternal Justice Campaign Director, MOMsRising, 
  submitted by Ms. Eshoo.........................................   223
Letter of February 12, 2020, to Mr. Pallone, et al., from Martin 
  H. Wolf, Director, Seventh Generation, submitted by Ms. Eshoo..   224
Letter of February 11, 2020, to Mr. Pallone, et al., from 
  Attorney General Group of New York, submitted by Ms. Eshoo.....   226
Letter of February 11, 2020, to Ms. Eshoo and Mr. Burgess, by 
  Annie Laurie Gaylor and Dan Barker, Co-President, Freedom from 
  Religion Foundation, submitted by Ms. Eshoo....................   232
Letter of February 12, 2020, to Mr. Pallone, et al., by Rabbi 
  Marla Feldman, Executive Director, Women of Reform Judaism, 
  Rabbi Jonah Dov Pesner, Director, Religious Action Center of 
  Reform Judaism, submitted by Ms. Eshoo.........................   234
Letter of February 12, 2020, to Committee on Energy and Commerce 
  and Subcommittee of Health, by Jacqueline Ayers, Vice 
  President, Government Relations and Public Policy, Planned 
  Parenthood Federation of America, Planned Parenthood Action 
  Fund, submitted by Ms. Eshoo...................................   237
Letter of February 12, 2020, to Mr. Pallone, et al., from 
  National Network of Abortion Funds, submitted by Ms. Eshoo.....   240
Letters to Mr. Pallone, et al., from MomsRising, submitted by Ms. 
  Eshoo \11\

----------
\9\ The information has been retained in committee files and also 
  is available at https://docs.house.gov/meetings/IF/IF14/
  20200212/110504/HHRG-116-IF14-20200212-SD039.pdf.
\10\ The information has been retained in committee files and 
  also is available at https://docs.house.gov/meetings/IF/IF14/
  20200212/110504/HHRG-116-IF14-20200212-SD025.pdf.
\11\ The information has been retained in committee files and 
  also is available at https://docs.house.gov/meetings/IF/IF14/
  20200212/110504/HHRG-116-IF14-20200212-SD026.pdf.
Letter of February 11, 2020, to Ms. Eshoo and Mr. Burgess, by 
  Vanita Gupta, President and CEO, Leadership Conference, 
  submitted by Ms. Eshoo.........................................   244
Letter of February 12, 2020, to Mr. Pallone, et al., by Sara 
  Hutchinson Ratcliffe, Acting President, Catholic for Choice, 
  submitted by Ms. Eshoo.........................................   248
Statement of February 12, 2020, from NARAL Pro-Choice, submitted 
  by Ms. Eshoo...................................................   250
Letter of February 10, 2020, to Mr. Pallone, et al., by Leila 
  Abolfazli, Director of Federal Reproductive Rights, submitted 
  by Ms. Eshoo...................................................   253
Letter of February 12, 2020, to Mr. Pallone, et al., by Barbara 
  S. Levy, MD, et al., submitted by Ms. Eshoo....................   256
Letter of February 12, 2020, to Mr. Pallone, et al., from the 
  five Law Professors, submitted by Ms. Eshoo....................   264
The Economic Consequences of Being Denied an Abortion, from 
  National Bureau of Economic Research, by Sarah Miller, et al., 
  submitted by Mr. Bilirakis \12\
Statement from Pam Thompson, submitted by Ms. Eshoo..............   269
Statement from Terri Nordone, submitted by Ms. Eshoo.............   270
Press Release of February 12, 2020, ``House Democrats Hold 
  Hearing Promoting Abortion on Demand Act," from Susan B. 
  Anthony List, submitted by Ms. Eshoo...........................   272
Letter of February 7, 2020, by Thomas McClusky, President, March 
  for Life Action, submitted by Ms. Eshoo........................   274
Article of February 10, 2020, ``Pro-Abortion House Members Need 
  to Back Off, Stop Attacking Women's Health: Americans United 
  for Life Rebukes the Effort of Some in the House to Invalidate 
  Health and Safety Standards, Americans United For Life,'' 
  submitted by Ms. Eshoo.........................................   275
Amici Brief of June, Medical Services v. Dr. Rebekah Gee, Supreme 
  Court Civil Action No. 18-1323 and 18-1460, submitted by Ms. 
  Eshoo \13\
Article ``Emotions and decision rightness over five years 
  following an abortion: An examination of decision difficulty 
  and abortion stigma,'' by Corinne H. Rocca, et al., Elsevier, 
  submitted by Mr. Ruiz..........................................   276

----------
\12\ The information has been retained in committee files and 
  also is available at https://docs.house.gov/meetings/IF/IF14/
  20200212/110504/HHRG-116-IF14-20200212-SD040.pdf.
\13\ The information has been retained in committee files and 
  also is available at https://docs.house.gov/meetings/IF/IF14/
  20200212/110504/HHRG-116-IF14-20200212-SD013.pdf.

 
          PROTECTING WOMEN'S ACCESS TO REPRODUCTIVE HEALTHCARE

                              ----------                              


                      WEDNESDAY, FEBRUARY 12, 2020

                  House of Representatives,
                            Subcommittee on Health,
                          Committee on Energy and Commerce,
                                                     Washington, DC
    The subcommittee met, pursuant to call, at 10:00 a.m., in 
the John D. Dingell Room 2123, Rayburn House Office Building, 
Hon. Anna G. Eshoo (chairwoman of the subcommittee) presiding.
    Members present: Representatives Eshoo, Engel, Butterfield, 
Matsui, Castor, Sarbanes, Lujan, Schrader, Kennedy, Cardenas, 
Ruiz, Dingell, Kuster, Kelly, Barragan, Blunt Rochester, 
Pallone (ex officio), Burgess, (subcommittee ranking member), 
Shimkus, Guthrie, Griffith, Bilirakis, Long, Bucshon, Brooks, 
Hudson, Carter, Gianforte, and Walden (ex officio).
    Staff present: Jacquelyn Bolen, Counsel; Jeffrey C. 
Carroll, Staff Director; Elizabeth Ertel, Office Manager; 
Austin Flack, Staff Assistant; Waverly Gordon, Deputy Chief 
Counsel; Tiffany Guarascio, Deputy Staff Director; Zach Kahan, 
Outreach and Member Service Coordinator; Aisling McDonough, 
Policy Coordinator; Meghan Mullon, Policy Analyst; Joe Orlando, 
Staff Assistant; Tim Robinson, Chief Counsel; Benjamin Tabor, 
Staff Assistant; Rebecca Tomilchik, Staff Assistant; Madison 
Wendell, Intern; C. J. Young, Press Secretary; Mike Bloomquist, 
Minority Staff Director; Jordan Davis, Minority Senior Advisor; 
Caleb Graff, Minority Professional Staff Member, Health; Tyler 
Greenberg, Minority Staff Assistant; Peter Kielty, Minority 
General Counsel; Ryan Long, Minority Deputy Staff Director; 
Kate O'Connor, Minority Chief Counsel, Communications and 
Technology; Zach Roday, Minority Communications Director; 
Kristin Seum, Minority Counsel, Health; and Kristen Shatynski, 
Minority Professional Staff Member, Health.
    Ms. Eshoo. Good morning, everyone. The Subcommittee on 
Health will now come to order.
    Let me just say that we will hear several deeply personal 
stories from our witnesses today and we are grateful on behalf 
of all of my colleagues to have you with us. We appreciate your 
being here today and the testimony that each one of you are 
going to give.
    Our subcommittee has always prided itself on a tradition of 
respect and collegiality and so I ask not only all the members 
but also, everyone that is here in the hearing room today to 
continue in that tradition.
    The Chair now recognizes herself for 5 minutes for an 
opening statement.

 OPENING STATEMENT OF HON. ANNA G. ESHOO, A REPRESENTATIVE IN 
             CONGRESS FROM THE STATE OF CALIFORNIA

    Nearly 50 years ago, the Supreme Court of the United States 
affirmed the right of every woman to make decisions about her 
own life, her body, and her future.
    Now that right is under threat by state laws restricting 
and banning reproductive healthcare and abortion care. Since 
2011, states have passed more than 450 medically unnecessary 
restrictions on reproductive care.
    For example, Alaska, Kansas, Oklahoma, and Texas force 
doctors to lie to their patients by having them inaccurately 
link abortion and breast cancer in their patient counseling.
    Louisiana, Texas, and Wisconsin require providers to 
perform medically unnecessary ultrasounds and show and describe 
the images to women who have already decided to have an 
abortion.
    Eighteen states have specific requirements for procedure 
rooms and corridors, as well as requiring facilities to be near 
and have relationships with local hospitals.
    These requirements do not improve patient care but 
purposely set expensive standards that make it difficult for 
clinics to stay open.
    Today, 90 percent of our counties in our country are 
without a single abortion provider and six states have only one 
clinic. So why is this a problem that the subcommittee should 
address?
    First, these restrictions deny women access to safe 
healthcare. Restricting abortion does not stop abortion. It 
makes it less safe.
    A nonpartisan study by the National Academies of Sciences 
found that the biggest threat to the quality and safety of 
abortion care are state regulations that create barriers to 
trained providers.
    When abortion is accessible and legal, it is extremely 
safe. The rate of serious complications in first-trimester 
abortions is less than .05 percent, making abortions 40 times 
safer than a colonoscopy.
    When abortion care is restricted, women face devastating 
consequences. The Landmark Turnaway Study, a five-year 
longitudinal study by researchers at UCSF, followed 1,000 women 
who sought, but did not always obtain, abortion care.
    The researchers found that the women who were denied 
healthcare consistently faced worse outcomes than those who 
received it.
    The women forced to carry a pregnancy were more likely to 
experience eclampsia and more likely to stay with abusive 
partners.
    They were four times more likely to be living below the 
poverty level. Two women who were denied abortion care died of 
pregnancy-related causes.
    Every day women across our country face the deeply personal 
decision of whether to continue pregnancy. They should be able 
to make their own decisions, together with their partner, their 
husband, their minister, their rabbi, and their priest, free 
from political interference.
    The Women's Health Protection Act ensures that every 
American woman has equal access to comprehensive reproductive 
healthcare, no matter where they live in our country.
    This legislation follows in the tradition of the Voting 
Rights Act of 1965, where Congress safeguarded a 
constitutionally-protected right. That is because states don't 
get to pick and choose what part of the Constitution to follow.
    When we support access to quality, affordable healthcare, 
we reduce the rate of unintended pregnancy. Today, the teen 
birthrate is at a record low. Total unplanned pregnancies 
recently hit the lowest level in 30 years.
    Any member who wants to reduce abortions can support public 
health programs have proven to reduce unintended pregnancies, 
including increased access to no-cost contraception as provided 
by the Affordable Care Act, comprehensive sex education that 
includes medically-accurate information, programs to support 
women facing domestic violence and sexual abuse, expanding 
Medicaid coverage rather than cutting it by $920 billion, as 
the president proposed this week in his released budget.
    [The prepared statement of Ms. Eshoo follows:]

                Prepared Statement of Hon. Anna G. Eshoo

    Nearly 50 years ago the Supreme Court affirmed the right of 
every woman to make decisions about her own life, body, and 
future.
    Now that right is under threat by state laws restricting 
and banning reproductive healthcare and abortion care.
    Since 2011 states have passed more than 450 medically 
unnecessary restrictions on reproductive care.
    For example, Alaska, Kansas, Oklahoma, and Texas force 
doctors to lie to their patients by having them inaccurately 
link abortion and breast cancer in their patient counseling.
    Louisiana, Texas, and Wisconsin require providers to 
perform medically unnecessary ultrasounds and show and describe 
the images to women who have already decided to have an 
abortion.
    Eighteen states have specific requirements for procedure 
rooms and corridors, as well as requiring facilities to be near 
and have relationships with local hospitals. These requirements 
do not improve patient care but set expensive standards that 
make it difficult for clinics to stay open.
    Today, 90 percent of counties in our country are without a 
single abortion provider, and six states have only one abortion 
clinic.
    So, why is this a problem that the Subcommittee should 
address?
    First, these restrictions deny women access to safe 
healthcare. Restricting abortion doesn't stop abortion. It 
makes it less safe.
    A nonpartisan study by the National Academies of Sciences 
found that the biggest threats to the quality and safety of 
abortion care are state regulations that create barriers to 
trained abortion providers.
    When abortion is accessible and legal, it is extremely 
safe. The rate of serious complications in first-trimester 
abortions is less than 0.05 percent, making abortion 40 times 
safer than a colonoscopy.
    But when abortion care is restricted, women face 
devastating consequences.
    The landmark Turnaway Study, a five-year longitudinal study 
by researchers at UCSF, followed 1,000 women who sought, but 
did not always obtain abortion care.
    The researchers found that the women who were denied 
healthcare consistently faced worse outcomes than those who 
received it.
    The women forced to carry a pregnancy were more likely to 
experience eclampsia and were more likely to stay with abusive 
partners. They were four times more likely to be living below 
the poverty level. Two women who were denied abortion care died 
of pregnancy-related causes.
    Every day women across our country face the deeply personal 
decision of whether to continue their pregnancies. They should 
be able to make their own decisions, free from political 
interference.
    The Women's Health Protection Act makes sure that every 
American has equal access to comprehensive reproductive 
healthcare, no matter where they live.
    This legislation follows in the tradition of the Voting 
Rights Act of 1965 where Congress safeguarded a 
constitutionally-protected right. That's because states don't 
get to pick and choose what part of the Constitution to follow.
    Any Member who wants to reduce abortions can accomplish 
this goal by supporting public health programs proven to reduce 
unintended pregnancies, including: Increased access to no cost 
contraception as provided in the Affordable Care Act, 
Comprehensive sex education that includes medically-accurate 
information, Programs to support women facing domestic violence 
and sexual abuse, and Expanding Medicaid coverage, rather than 
cutting it by $920 billion as the President has proposed in his 
budget released this week.
    When we support access to quality, affordable healthcare, 
we reduce the rate of unintended pregnancy. Today the teen 
birth rate is at a record low. Total unplanned pregnancies 
recently hit the lowest level in 30 years.
    Lastly, we will hear several deeply personal stories from 
our witnesses today. I'm grateful to them. Our Subcommittee 
prides itself on a tradition of respect and collegiality.
    I ask Members to continue in that tradition today.

    The Chair now recognizes Mr. Burgess, the ranking member of 
the Subcommittee on Health, for his 5 minutes for an opening 
statement.

OPENING STATEMENT OF HON. MICHAEL C. BURGESS, A REPRESENTATIVE 
              IN CONGRESS FROM THE STATE OF TEXAS

    Mr. Burgess.  And I thank the Chair.
    I do feel that today's hearing is an indication of where 
the Democratic Party is headed. The policy concerns surrounding 
abortion and the right to life are not new.
    But a bill such as H.R. 2975, with over 200 members of the 
Democratic Party in support, is, in fact unprecedented. This 
bill before us today transcends pro-life and pro-choice issues.
    The question of abortion, sometimes reduced to yet another 
political issue, is personal for some of us. It is personal for 
me. My belief in the right to life has influenced my 
professional career for much longer than my time in Congress.
    Before being elected to represent the 26th District of 
Texas, I spent over 25 years practicing as an OB-GYN in North 
Texas. My medical career was rooted in my pro-life practice and 
the belief that all life had meaningful potential.
    In the span of my career in obstetrics, I delivered more 
than 3,000 babies. Not only did I have the joy of seeing these 
babies when they were delivered, but throughout my career, I 
witnessed great advances in technology.
    It is interesting at the time that Roe v. Wade was 
adjudicated by the Supreme Court, sonography was itself in its 
infancy. It is technology that was really only available to me 
in the latter half of my residency at Parkland Hospital and 
they have seen great strides.
    And yes, for those of us who have watched a baby with 
purposeful movements in utero, there is no question to me about 
the sanctity of life.
    While my work has changed, I now spend late nights 
delivering policy rather than babies. My dedication to pro-life 
medicine remains steadfast.
    Ironically, the bill is called the Women's Health 
Protection Act of 2019, even though if this bill became law, it 
would put women's health and safety at risk.
    The heavy-handed language that this bill uses is what 
places that risk by codifying that there may be no 
restrictions, no prohibitions, on any particular abortion 
procedure prior to viability, may place at risk a number of 
women to potential harm associated with certain abortion 
procedures and complications, such as infection, bleeding, 
uterine perforation with no ability to regulate for safety 
purposes.
    Not only does the bill raise questions about the Democrats' 
concern for women's health and safety, it also raises questions 
about the regard for the United States Constitution.
    The Supreme Court established the viability tests in Roe v. 
Wade in 1971. The standard says that once a baby reaches the 
point of viability, a state may regulate or prohibit abortions.
    In Justice Blackman's opinion in Roe v. Wade, he stated the 
viability is usually placed at about seven months, or 28 weeks 
gestation, but it may occur earlier, even at 24 weeks.
    In 1973, a baby being born 24 weeks was--had very dim 
chances for survival. But I will tell you, throughout my 
career, the youngest gestational age baby that I personally 
delivered was 23 weeks and that child went on not just to 
survive but to thrive without any neurological sequelae.
    Last week at the State of the Union, President Trump 
recognized a young woman--a young girl--and her mother in the 
crowd. This youngster, Ellie Schneider, was born severely 
premature at 21 weeks. Ellie is now perhaps the youngest baby 
to survive early gestational delivery in the United States and 
she is now a happy and healthy two-year-old.
    So, for me, it is incredible to see the medical advances 
saving the lives of mothers and babies.
    As the viability of a baby occurs earlier with the help of 
medical innovation, the Roe v. Wade standard inherently extends 
the rights of states to regulate earlier in a pregnancy term.
    A bill like this seems to override--seeks to override and 
dismiss the viability standard set by the Supreme Court in the 
wake of medical advances that are saving babies' lives.
    The bill would also codify into law that access to an 
abortion is essential to women's health and in fact is contrary 
to one of the founding principle of our country, which is a 
right to life.
    The Federal Government should work to overcome the factors 
that lead to abortions and should support well-crafted 
legislative proposals that directly address these factors. But 
that is not this bill.
    I am a physician. Most members of Congress are not. If this 
bill does cross the line, it is perhaps the most uncomfortable 
and threatening legislation that I have seen that threatens not 
just hospitals, doctors, but the very women patients we serve.
    I yield back my time.
    [The prepared statement of Mr. Burgess follows:]

             Prepared Statement of Hon. Michael C. Burgess

    Thank you, Madam Chair. today's hearing is an unfortunate 
indication of where the Democratic party is headed. While the 
policy concerns surrounding abortion and a right to life are 
not new, a bill such as H.R. 2975, with over 200 members of the 
Democratic party in support, is unprecedented. This bill 
transcends pro-life and pro-choice.
    The question of abortion, sometimes reduced to yet another 
political issue to debate, is personal for me. My belief in the 
right to life has influenced my professional career for much 
longer than my time in Congress. In fact, it's been a lifetime. 
Before being elected to represent the 26th District of Texas, I 
spent almost three decades practicing as an OB/GYN in North 
Texas. My medical career was rooted in my pro-life practice and 
the belief that all life has meaningful potential.
    In the span of my obstetrics career, I delivered more than 
3,000 babies. Not only did I have the joy of seeing these 
babies when they were delivered, but throughout my careerI 
witnessed great advances in the technology that allowed doctors 
and parents to see these children developing in the womb. For 
those of us who have watched a babysquirm and kick during a 
sonogram, there is no question about the sanctity of life.
    While my work has changed through the years--I now spend 
late nights delivering policy rather than babies--my dedication 
to pro-life medicine remains steadfast.
    Ironically, this bill is called the Women's Health 
Protection Act of 2019, even though, if this bill became law, 
it would put women's health and safety at risk. The heavy-
handed language used in this bill puts women at risk.
    By codifying that there may be no restrictions or 
prohibitions on particular abortion procedure prior to 
viability, women may be placed at risk of a number of potential 
harms associated with certain abortion procedures such as 
infection, bleeding, or uterine perforation, without the 
ability to be regulated for safety purposes.
    Not only does this bill raise questions about the 
Democrats' concern for women's health and safety, it also 
raises questions about the regard for the U.S. Constitution. 
The Supreme Court established the viability test in Roe v. Wade 
in 1971. This standard says that once a baby reaches the point 
of ``viability,'' a state may regulate or prohibit abortions.
    In Roe v. Wade, Justice Blackmuns' opinion states that 
viability is usually placed at about seven months - or 28 weeks 
- but may occur earlier, even at 24 weeks. In 1973, a viable 
baby being born at 24 weeks was something to hope for in the 
future.
    The youngest baby I delivered was at 23 weeks. Last week, 
at the State of the Union, President Trump recognized a young 
girl and her mother in the crowd. This young girl, Ellie 
Schneider, was born severely premature at 21 weeks. Ellie is 
one of the youngest babies to survive in the US and she is now 
a happy and healthy two-year-old. As an OB/GYN it is incredible 
to see the medical advances saving the lives of mothers and 
babies.
    As the viability of a baby occurs earlier with the help of 
medical innovation, the Roe v. Wade standard inherently extends 
the rights of states to regulate earlier in a pregnancy term. A 
bill like this seeks to override and dismiss the viability 
standard set by the Supreme Court in the wake of medical 
advances that are saving babies lives.
    This bill would codify into law that access to an abortion 
is essential to women's health.
    This is contrary to the US Constitution, which is very 
clear when it guarantees a right to life.
    The Federal Government should work to overcome the factors 
that lead to abortions and should support well-crafted 
legislative proposals that directly address these factors.
    That is not this bill.
    I am a physician, but most Members of Congress are not. For 
me, this bill crosses a line into dictating the practice of 
medicine, which is uncomfortable and threatening to health care 
practitioners and hospitals across the country.
    I yield back.

    Ms. Eshoo. The gentleman yields back.
    It is a pleasure to recognize the chairman of the full 
committee, Mr. Pallone, for 5 minutes for his opening 
statement.

OPENING STATEMENT OF HON. FRANK PALLONE, Jr., A REPRESENTATIVE 
            IN CONGRESS FROM THE STATE OF NEW JERSEY

    Mr. Pallone. Thank you, Madam Chair.
    Today's hearing is on legislation to protect women's access 
to abortion care. This legislation is necessary today because 
states have passed an onslaught of ideological bans and 
restrictions intended to interfere with women's personal 
medical decision-making and to severely limit women's access to 
abortion care.
    Since 2011 alone, anti-abortion state lawmakers have passed 
nearly 450 restrictive laws with the sole purpose of making it 
more difficult for women to access this care.
    They have passed mandatory waiting periods, requirements 
for multiple in-person visits, and requirements that doctors 
provide their patients with medically inaccurate information 
about the potential risks of the procedure.
    They have also passed ridiculous and unnecessary building 
requirements for abortion providers that are intended solely to 
shut down clinics that provide abortion services.
    And the result of these increasingly restrictive laws is 
that women all across the country are having a harder time 
accessing abortion care, which they have a constitutional right 
to obtain.
    Comprehensive healthcare means having access to affordable 
abortion care, which is a safe medical procedure with far fewer 
risks than many routine medical procedures.
    Repeated studies have confirmed the safety of abortion, 
including comprehensive findings by the National Academies of 
Science, Engineering, and Medicine.
    It is a legal and safe procedure, but ideological state 
legislators continue to put up roadblocks for women and 
providers.
    Today, nearly 90 percent of American counties are without a 
single abortion provider and six states only have one abortion 
clinic in the entire state.
    The unfortunate reality in America is that your 
constitutionally guaranteedhealthcare rights are now dependent 
upon where you live, and that is simply wrong.
    Sadly, we know that anti-abortion restrictions fall hardest 
on those who already face significant barriers to healthcare, 
and that is low-income women, women of color, LGBTQ people, 
young people, and people living in rural communities.
    At a time when we should all be working together to reduce 
healthcare disparities, we are watching states across the 
country actively pass legislation that increases those 
disparities.
    And their actions are putting access to care further out of 
reach. One particularly alarming study from the Center for 
Reproductive Rights and Ibis Reproductive Health found that 
states with more anti-abortion laws have poorer health outcomes 
generally for both women and children than states that have 
fewer restrictions.
    This should be alarming to all of us, especially as we are 
faced with an increasingly dire national maternal health crisis 
that we also know disproportionately impacts women of color.
    It is for all of these reasons that we are holding this 
important and timely hearing on the Women's Health Protection 
Act. This legislation simply ensures that patients can access, 
and healthcare providers can provide, abortion services. It 
prevents medically unnecessary and burdensome restrictions that 
single out abortion services and deny women access to care.
    It is long past time that we affirm women's healthcare 
rights by ensuring that they can actually utilize those rights. 
The Women's Health Protection Act would do just that by 
ensuring the constitutional right to have an abortion is a 
reality for all people, no matter where they live.
    And, finally, I want to thank our witnesses for being here 
today. I know that this can be a very personal and, at times, 
difficult conversation to have in a public setting and I want 
to express my sincere thanks and appreciation for all of you 
for being here today and sharing your experiences and expertise 
with the committee.
    [The prepared statement of Mr. Pallone follows:]

             Prepared Statement of Hon. Frank Pallone, Jr.

    Today's hearing is on legislation to protect women's access 
to abortion care.
    This legislation is necessary today because states have 
passed an onslaught of ideological bans and restrictions 
intended to interfere with women's personal medical 
decisionmaking and to severely limit women's access to abortion 
care.
    Since 2011 alone, anti-abortion state lawmakers have passed 
nearly 450 restrictive laws with the sole purpose of making it 
more difficult for women to access this care.
    They've passed mandatory waiting periods, requirements for 
multiple in-person visits, and requirements that doctors 
provide their patients with medically inaccurate information 
about the potential risks of the procedure. They have also 
passed ridiculous and unnecessary building requirements for 
abortion providers that are intended solely to shut down 
clinics that provide abortion services.
    The result of these increasingly restrictive laws is that 
women all across the country are having a harder time accessing 
abortion care, which they have a constitutional right to 
obtain. Comprehensive health care means having access to 
affordable abortion care, which is a safe medical procedure 
with far fewer risks than many routine medical procedures. 
Repeated studies have confirmed the safety of abortion, 
including comprehensive findings by the National Academics of 
Science, Engineering, and Medicine.
    It is a legal and safe procedure, but ideological state 
legislators continue to put up roadblocks for women and 
providers.
    Today, nearly 90 percent of American counties are without a 
single abortion provider, and six states only have one abortion 
clinic in the entire state. The unfortunate reality in America 
is that your constitutionally guaranteed health care rights are 
now dependent upon where you live, and that is wrong.
    Sadly, we know that anti-abortion restrictions fall hardest 
on those who already face significant barriers to health care: 
low-income women, women of color, LGBTQ people, young people, 
and people living in rural communities. At a time when we 
should all be working together to reduce health care 
disparities, we are watching states across the country actively 
pass legislation that increases those disparities.
    Their actions are putting access to care further out of 
reach. One particularly alarming study from the Center for 
Reproductive Rights and Ibis Reproductive Health found that 
states with more anti-abortion laws have poorer health outcomes 
generally for both women and children than states that have 
fewer restrictions. This should be alarming to all of us 
especially as we are faced with an increasingly dire national 
maternal health crisis that we also know disproportionately 
impacts women of color.
    It is for all of these reasons that we are holding this 
important and timely hearing on the Women's Health Protection 
Act. This legislation simply ensures that patients can access, 
and health care providers can provide, abortion services. It 
prevents medically unnecessary and burdensome restrictions that 
single out abortion services and deny women access to care. It 
is long past time that we affirm women's healthcare rights by 
ensuring that they can actually utilize those rights. The 
Women's Health Protection Act would do just that by ensuring 
the constitutional right to have an abortion is a reality for 
all people, no matter where they live.
    Finally, I want to thank our witnesses for being here 
today. I know that this can be a very personal and at times 
difficult conversation to have in a public setting. I want to 
express my sincere thanks and appreciation for being here today 
and sharing your experience and expertise with the Committee.
    With that, I would like to yield the remainder of my time 
to Representative Schakowsky.

    And I would like to yield a minute and a half to 
Representative Schakowsky.
    Ms. Schakowsky. I thank the gentleman for yielding to me.
    Abortion is healthcare, and healthcare is a human right. 
This hearing is historic but it is about time that the Congress 
has finally weighed in and said that we do support the right of 
women regardless of color, of income, of state, of zip code, to 
have thehealthcare that they need.
    This is about the women who deserve comprehensive 
reproductive healthcare, all of them. And for the first time in 
over 20 years our committee is considering a proactive bill 
that would guarantee the constitutional right to abortion care 
free from the interference of any politician who has no place 
in making this very personal decision.
    Protecting access to abortion care isn't the beginning of 
women having abortions. But it is the end of women dying from 
abortions.
    We will not go back no matter what is happening in states 
around the country. Women will go forward together to protect 
our rights.
    And I yield back.
    Mr. Pallone. And I yield back.
    Ms. Eshoo. The gentleman yields back.
    It is a pleasure to recognize Mr. Walden, the ranking 
member of the full committee, for his 5 minutes of an opening 
statement.

   OPENING STATEMENT OF HON. GREG WALDEN A REPRESENTATIVE IN 
               CONGRESS FROM THE STATE OF OREGON

    Mr. Walden. Well, thank you, Madam Chair.
    During the State of the Union Address, President Trump 
welcomed and spoke about Ellie Schneider. Remember, she was the 
little girl who was delivered at just 21 weeks gestation.
    The president called for policies to protect the unborn 
after fetal viability. Following the State of the Union, the 
Senate Judiciary Committee held a hearing on medical care for 
children born alive.
    Instead of considering these policies, we are, regrettably, 
convened here today to discuss yet another deceptively titled 
partisan bill that has no chance of becoming law or being 
considered by the Senate.
    We all know the issue of abortion is a very sensitive one. 
It is a painful topic for the women and men who, for whatever 
reason, find themselves facing the dilemma of whether or not to 
terminate a pregnancy and, in turn, a human life.
    Abortion is one of the most polarizing subjects in American 
political discourse but even many people that consider 
themselves pro-choice believe some restrictions are 
appropriate.
    Seven in ten Americans support substantial restrictions on 
abortion after three months of pregnancy. Even nearly half of 
those who identify as pro-choice support restrictions on late 
term abortions.
    Indeed, fewer than four in ten Democrats support abortion 
at any time and for any reason, which is why I am so concerned 
we are considering a bill so sweeping and out of sync with the 
views of the majority of Americans, a bill that seeks to strip 
away even the most minimal protections for women and their 
unborn children at any stage of prenatal development.
    Even the original Roe v. Wade ruling never envisioned the 
extreme position reflected in this bill. By overturning nearly 
all federal and state limitations on abortion, the deceptively- 
named Women's Health Protection Act would require the 
provisions of abortion on demand at any stage of pregnancy 
regardless of any compelling interest in the welfare of the 
patient, the protection of human life, or the conscience of the 
health practitioner.
    I will oppose this bill for Oregonians like Elizabeth 
Gillette, who told me about her heartbreaking experience of 
getting an abortion in 2011.
    In her letter, which I would like to submit for the record, 
Madam Chair, Elizabeth states that, quote, ``On-demand 
abortions are not putting the safety of the woman as the 
highest priority.
    Because chemical abortion is a procedure that encompasses 
risk both physical and emotional it should not be thought of as 
a routine procedure. We need to protect the health of women. It 
is my deepest hope no woman would have to suffer, as I did,'' 
closed quote.
    [The prepared statement of Mr. Walden follows:]

                 Prepared Statement of Hon. Greg Walden

    Thank you, Madame Chair. During the State of the Union 
address, President Trump welcomed and spoke about Ellie 
Schneider, a little girl who was delivered at just 21 weeks' 
gestation. The President called for policies to protect the 
unborn after fetal viability. Following the State of the Union, 
the Senate Judiciary held a hearing on Medical Care for 
Children Born Alive. Instead of considering these policies, we 
are regrettably convened here today to discuss yet another, 
deceptively titled, partisan bill that has no chance of being 
considered by the Senate nor signed into law.
    The issue of abortion is a very sensitive one. It is a 
painful topic for the women and men who for whatever reason 
find themselves facing the dilemma of whether or not to 
terminate a pregnancy, and in turn, a human life. Abortion is 
one of the most polarizing subjects in American political 
discourse, but even many people that consider themselves pro-
choice believe some restrictions are appropriate. Seven in ten 
Americans support substantial restrictions on abortion after 
three months of pregnancy. \1\ Even nearly half of those who 
identify as pro-choicesupport restrictions on late-term 
abortions. Indeed, fewer than four in ten Democrats support 
abortion at any time and for any \2\ reason. \3\
---------------------------------------------------------------------------
    \1\ https://www.wsj.com/articles/waiting-for-a-moderate-democrat-
on-abortion-11579651418.
    \2\ https://www.wsj.com/articles/waiting-for-a-moderate-democrat-
on-abortion-11579651418.
    \3\ https://www.kofc.org/un/en/resources/communications/american-
attitudes-abortion-knights-of-columbusmarist-poll-slides.pdf.
---------------------------------------------------------------------------
    Which is why I am so concerned that we are considering a 
bill so sweeping and out of sync with the views of a majority 
of Americans. A bill that seeks to strip away even the most 
minimal protections for women and their unborn children, at any 
stage of prenatal development. Even the original Roe v. Wade 
ruling never envisioned the extreme positions reflected in this 
bill. By overturning nearly ALL federal and state limitations 
on abortion, the deceptively named Women's Health Protection 
Act would require the provision of abortions on demand, at any 
stage of pregnancy, regardless of any compelling interest in 
the welfare of the patient, the protection of human life, or 
the conscience of the health practitioner.
    I oppose this bill for Oregonians like Elizabeth Gillette, 
who told me about her heartbreaking experience of getting an 
abortion in 2011. In her letter, which I would like to submit 
for the record, Elizabeth states that "on demand abortions are 
not putting the safety of the woman as the highest priority. 
Because chemical abortion is a procedure that encompasses 
risks, both physical and emotional, it should not be thought of 
as a routine procedure. We need to protect the health of women. 
It is my deepest hope that no woman would have to suffer as I 
did." And with that I would like to yield my remaining time to 
the gentle lady from Washington.
    With that, I would like to yield the remainder of my time 
to the gentle lady from Washington, Mrs. Rodgers.
    Mrs. Rodgers.  I thank the ranking member and the Chair for 
allowing me to participate today.
    At times like this each one of us reflect on our own 
journey. As human beings we go through so many ups and downs. I 
was 35 and single when I was elected to Congress, and before I 
met my husband I wasn't sure about kids or if I was even a baby 
person.
    I had traveled. I had met amazing people. I had had 
extraordinary opportunities that I am grateful to God for every 
single day.
    But I can testify today that the best thing in my life has 
been becoming a mom. There is nothing more amazing than 
bringing a new life into the world.
    Again, there was a time when I was fearful. I was 
uncertain. Even when I was pregnant it was scary. It was 
overwhelming. And in that moment, I could see the fear of the 
unknown making a person question everything.
    Now I am so grateful that it happened. Today, I am a 
working mom of three. My oldest has Down Syndrome and is one of 
the best things that has happened in my life.
    I also want to share Linda's story from Washington State. 
She had an abortion when she was in college and she said, 
quote, ``The best thing I can remember about the abortion 
clinic was that no one seemed to care. They didn't care that I 
was there to end a life. They didn't seem to care about me as a 
person and they didn't follow up to make sure that I was OK.''
    Today, Linda has two adult children but she still wonders. 
I quote: she said, ``What about the one that I aborted? What 
would she or he be like today?''
    I urge us all to remember Linda's story as some move to 
this extreme where nearly unlimited abortions at nearly every 
stage of pregnancy would be the law of the land.
    Our country needs hope. America needs hope and healing. 
Abortion doesn't bring hope or healing. There is a despair that 
has come over our country.
    Do you know what despair is? Despair is a complete lack of 
hope. It is hopelessness. I urge my colleagues to reconsider 
this legislation.
    I yield back.
    Ms. Eshoo. The gentleman yields back and asks for unanimous 
consent to have something placed in the record.
    So ordered.
    [The information appears at the conclusion of the hearing.]
    Ms. Eshoo. The Chair now will move to the--to our witnesses 
for their statements and, again, we appreciate each one of you 
being here.
    Dr. Yashica Robinson is the medical director of the Alabama 
Women's Center for Reproductive Alternatives. Welcome to you.
    Ms. Georgette Forney, co-founder of the Silent No More 
awareness campaign. Welcome to you and thank you.
    Teresa Stanton Collett is a professor of law and director 
of the Pro-Life Center at the University of St. Thomas School 
of Law in Minneapolis. Welcome to you.
    Nancy Northup, the president and CEO of the Center for 
Reproductive Rights. Thank you for being here.
    And Holly Alvarado, who is a retired staff sergeant of the 
United States Air Force.
    So, again, thank you and welcome to each one of you.
    I think you are probably familiar with the lighting system. 
Green, obviously, is go. Yellow, you slow down, and red you 
stop. OK.
    So, Dr. Robinson, you are recognized for 5 minutes for your 
testimony.

 STATEMENTS OF DR. YASHICA ROBINSON, MEDICAL DIRECTOR, ALABAMA 
WOMEN'S CENTER FOR REPRODUCTIVE ALTERNATIVES; GEORGETTE FORNEY, 
 PRESIDENT OF ANGLICANS FOR LIFE, CO-FOUNDER OF THE SILENT NO 
    MORE AWARENESS CAMPAIGN; TERESA STANTON COLLETT, J.D., 
PROFESSOR OF LAW; NANCY NORTHUP, PRESIDENT AND CEO, CENTER FOR 
       REPRODUCTIVE RIGHTS; AND HOLLY ALVARADO, ADVOCATE

    Dr. Robinson. Thank you, and good morning.

              STATEMENTS OF YASHICA ROBINSON, M.D.

    Good morning, Chairwoman Eshoo, Ranking Member Burgess, and 
members of the subcommittee.
    My name is Dr. Yashica Robinson. I am a board-certified 
obstetrician and gynecologist. I serve on the board of 
Physicians for Reproductive Health and I am the medical 
director of Alabama Women's Center for Reproductive 
Alternatives in Huntsville, Alabama.
    Thank you for the opportunity to speak with you in support 
of the Women's Health Protection Act.
    At my obstetrics practice, I provide prenatal care, deliver 
babies, and treat mothers after they give birth. I also provide 
abortion care because I believe that patients deserve the full 
spectrum of reproductive healthcare options.
    I came to this work because of my passion as a young 
mother. I know that young people--I am sorry, I came to this 
work because of my passion for young people, one that is deeply 
connected to my personal experience.
    In high school, I learned that I was pregnant. As a result 
of fear and lack of resources, by the time I confided in my 
family I had no choice. I was going to be a mother.
    Becoming a mother came with many harsh realities. I love my 
children with all my heart but I know that everyone should be 
able to make the decision to parent for themselves.
    I am proud to provide patients with compassionate quality 
care when they enter our doors and I support this bill because 
access to care should never depend on your zip code.
    In states like California or Maryland a patient can access 
abortion care without the state forcing medically inaccurate 
information on them or making them endure a mandatory delay.
    This is what care should look like. Unfortunately, that is 
not the case for many patients in Alabama. Last year, the 
Alabama legislature passed a near total ban on abortion. It 
would threaten doctors like myself with prison for providing 
ethical medically-appropriate care for simply doing our jobs.
    Represented by the ACLU, I, and other providers, filed suit 
to prevent this ban from taking effect. Thankfully, it was 
blocked and abortion remains legal in Alabama.
    However, decades of medically unnecessary restrictions have 
taken their toll in Alabama. It is not unusually for patients 
to travel up to eight hours to reach us because so many other 
providers have been forced to close. Then they are required to 
wait an additional 48 hours before I can provide the care they 
need.
    I know people who have slept in their cars overnight as a 
result of this state- mandated delay. The state also requires 
my patients to receive outdated materials as part of so-called 
counseling.
    These materials are filled with misinformation that I later 
have to correct. We are required to do ultrasound examinations 
even when they are unnecessary and provide no medical value. 
The effect of these needless costs and delays on my patients 
are so painful for me to see.
    Over the years, my practice has been forced to comply with 
onerous medically- unnecessary building requirements. For 
example, we were forced to install 24-hour lighting even though 
we can't see patients after 5:00 p.m. because of a local 
regulation.
    This has nothing to do with safety at all. The local anti- 
abortion group even drafted legislation making it illegal to 
operate an abortion clinic within 2,000 feet of a school, 
specifically designed to shut our clinic down. A court struck 
that down, recognizing it as just another thinly- veiled 
attempt to push abortion out of reach for patients.
    In 2018, the National Academies of Science, Engineering, 
and Medicine published a comprehensive study affirming that 
abortion is extremely safe and the biggest threat to patient 
safety is the litany of medically unnecessary regulations that 
raise costs and delay care.
    They confirmed that access to safe abortion depends on 
where you live and how much money you have.
    Alabama is a state with an unconscionably high maternal and 
infant mortality rate. According to the Alabama Department of 
Public Health, nearly two-thirds of Alabama counties lack 
hospitals where obstetrical care is provided.
    In Alabama, black women are nearly five times more likely 
to die of pregnancy-related causes than white women and many 
preexisting conditions can be made worse during pregnancy, and 
other serious health-related conditions can be caused by 
pregnancy.
    Without access to abortion, maternal mortality rates will 
rise even more.
    The bottom line is this. Abortion is healthcare. The 
Women's Health Protection Act would bring needed federal 
protections for my patients and safeguard their rights.
    Protection abortion will also protect access to pregnancy 
care because they are interconnected. Healthcare should be 
patient centered and medical decisions should remain between 
the patient and her physician without any political 
interference.
    Thank you.
    [The prepared statement of Dr. Robinson follows:]
    [GRAPHICS NOT AVAILABLE IN TIFF FORMAT]      
    
    Ms. Eshoo. Thank you, Dr. Robinson.
    Ms. Forney, you're recognized for your 5 minutes of 
testimony for the committee, and thank you again for being 
here.

                 STATEMENT OF GEORGETTE FORNEY

    Ms. Forney. Push the magic button. Do I wait till I get the 
green light?
    [Laughter.]
    Ms. Forney. There we go.
    Thank you for inviting me to testify today. My name is 
Georgette Forney and I am here as a woman who had an abortion 
and has spent the last 22 years helping others who regret their 
abortion.
    Sorry, I get so emotional.
    As the co-founder of the Silent No More awareness campaign, 
I speak on behalf of the 19,582 people who are registered to be 
silent no more.
    We want you to know that abortion didn't solve our 
problems. It just created different ones. When I was 16 and I 
found out I was pregnant; I was scared. A baby felt like a 
threat to my future.
    I didn't know what abortion was but my friend told me it 
would fix my problem. As I drove to the clinic that day my 
heart said, this feels wrong. But the fear in me said, it's 
legal so it must be OK.
    For 19 years after my abortion, I pretended it was no big 
deal. But the reality was I wouldn't allow myself to face the 
truth of what I had done. I had aborted a human being.
    Once I made that connection, everything changed for me. You 
know, as long as we stay in that place of denial it is OK. We 
are OK. The problem is that sometimes something will trigger 
us--the birth of a child, the death of a loved one, a parent, 
or even a sonogram image.
    At the March for Life last month, 31 women shared their 
testimony for the first time outside of the Supreme Court. They 
each told why they had their abortion.
    They talked about what the procedure was like, what 
happened immediately afterwards, what were the long-term 
consequences, and then, finally, how they found help in 
healing.
    Here are some quick excerpts.
    Chelsea: My boyfriend, friends, and family all agreed that 
an abortion was the best choice for my circumstances.
    Lynn: I was one month from graduating from college and had 
just signed my first teaching contract.
    Cindy: I was told that the tugging would be like strong 
menstrual cramps. What I felt was intense pain as though not 
only my baby but my soul was being suctioned out.
    Kelly: When I went in, I was treated with no compassion, 
just like a cow going off to slaughter.
    Laura: When I left Planned Parenthood that day, I promised 
myself I would never think about it or talk about this day ever 
again.
    Virginia: Immediately afterwards, I forced myself to shut 
out the reality of what had happened. I had taken care of my 
problem.
    Cecilia: My life spiralled into a life of self-hatred, 
drugs, alcohol, and relationships. I ended up having three more 
abortions. Each time I felt like my life was being sucked out 
of me. I was dead inside. Empty.
    Lynn, North Carolina: I became an angry militant advocate 
for abortion. But over a year later, the guilt and horror of 
what I had done and the resulting depression, drug abuse, and 
self-loathing started consuming my life.
    The women of Silent No More publicly share--speak publicly 
about their abortions. But many more are silent and seek help 
quietly. The campaign partners with more than 40 different 
abortion after-care programs helping women both nationally and 
internationally.
    One program alone, Rachel's Vineyard, has helped over 
326,000 individuals. These organizations have grown as women 
reach out to us for help because they are dealing with 
nightmares, depression, suicidal feelings and attempts, eating 
disorders, addiction, sexual dysfunction, and, most common, a 
low sense of self-esteem.
    If abortion is no big deal, why are all these people going 
through healing programs? Also, there is clear evidence that 
tighter regulations of abortion clinics are needed.
    Consider the filthy Gosnell clinic in Philadelphia where 
Karnamaya Monger died, or the St. Louis Planned Parenthood that 
failed relicensing inspection last year when the DHSS 
discovered four women had suffered from major abortion 
complications. Or consider Preterm in Cleveland where a 
haemorrhaging abortion patient had to call 911 herself after 
being kicked out of the clinic because they were closing.
    And then there are women who can't speak. Keisha Atkins 
died at 23 in Albuquerque during a late-term abortion. Tonya 
Reaves died in Chicago after bleeding for hours after three 
botched abortion attempts. She was 24 and the mother of a baby.
    Jennifer Morbelli was 29 when she died. Cree Erwin was 24 
when she died of an incomplete abortion in Michigan. Tell the 
families of these women that abortion must be protected.
    You say that abortion restrictions impact women of color. 
But the inconvenient truth is that women of color are being 
killed in the recent years more than the white women, like 
Cree, Tonya, and Keisha.
    Or how about Lakisha Wilson, Jamie Lee Morales, or Maria 
Santiago? Do their black lives and Hispanic lives matter?
    We need legislation that requires every state to report 
every abortion, every incident of physical harm by abortion, 
and every woman that dies by legal abortion is acknowledged. 
Let us get the facts. Trust women with the facts, not rhetoric.
    Thank you.
    [The prepared statement of Ms. Forney follows:]
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    Ms. Eshoo. Ms. Forney, you are almost a minute over time.
    Thank you for your testimony.
    I now would like to recognize Ms. Stanton Collett for your 
5 minutes for testimony.

              STATEMENT OF TERESA STANTON COLLETT

    Ms. Collett. Thank you, Madam Chair.
    Ms. Eshoo. Turn your microphone on.
    Ms. Collett. Thank you, Madam Chair.
    Ms. Eshoo. Great. That is good.
    Ms. Collett. Ranking Member Burgess, members of the 
subcommittee. My name is Teresa Collett. I am a law professor 
in Minneapolis, as the chairwoman mentioned.
    I also, however, have a fairly robust litigation practice--
--
    Mr. Shimkus.  Madam Chair, she may need to pull her mic a 
little bit closer to her.
    Ms. Collett. Thank you.
    I also have a fairly robust litigation practice and have 
represented numerous public officials and amicus briefs before 
the U.S. Supreme Court, federal courts of appeals, and state 
supreme courts.
    I have also had the privilege of serving as special 
attorney general or special counsel to the states of Oklahoma, 
New Hampshire, and also in Kansas.
    That is the basis of my testimony today, which represents 
my personal views, not the views of my employer, the University 
of St. Thomas.
    It is important to note what is absent from this bill, at 
the outset.
    Number one, while the bill recognizes that abortion is 
constitutionally protected, it fails to recognize the unique 
nature of abortion.
    Abortion, unlike the other procedures that are listed as 
comparable procedures in the legislation, in the words of the 
Eighth Circuit, ends the separate unique human life.
    There is no other medical procedure that is undertaken in 
this country where that is permitted. It is also important to 
note that many of the premises of this bill are simply false.
    The first congressional finding in the bill suggests that 
abortion access is a necessary precondition to a woman's full 
participation in the economic and social life of this country.
    To that extent, it is a version of what the Supreme Court 
plurality said in Planned Parenthood v. Casey. But when that 
case was decided, abortion rights were already beginning their 
steep decline.
    The simple fact is that from 1991 to 2016, the last year in 
which we have statistics from the CDC regarding the rate of 
abortion, abortions have declined more than 50 percent, going 
from an annual rate of 24 per 1,000 women to 11.6.
    During that time period, women's participation in the 
workforce has remained, largely, steady including participation 
by women who have children under the age of 18. During that 
time also, women's educational achievement has skyrocketed.
    According to the Bureau of Labor Statistics, women's 
college degrees have quadrupled from 1970 to 2018. In addition 
to that, women's business--women-owned businesses have 
increased 42 percent, according to the American Express Study 
in 2019 of women's businesses. They contribute $1.9 trillion to 
the national economy.
    The simple fact is there is no correlation between access 
to abortion and women's participation in the economic and 
social life of this country.
    To the extent that there is a correlation, it appears to be 
a negative correlation. But I won't insult the members of this 
committee by suggesting that's a truth. We all know that 
correlation and causation are very different things.
    But women are succeeding in this society while abortion 
rates are falling rapidly. There is no correlation.
    My second point is that the restructuring of the abortion 
market is in response to that steep decline. While it is said 
many times already today that abortion access is a necessary 
component of healthcare, the committee ignores in this 
legislation the fact that 54 percent of all counties in this 
country have no hospitals providing obstetric services.
    Dr. Robinson testified to that fact today and said in 
Alabama it's an even greater number of hospitals that provide 
no obstetric services. That is an outrage.
    If you were really concerned about women's health, that 
would be your primary concern. In addition to that, we also see 
that there is a restructuring by the major market force in that 
industry.
    The industry, of course, is led by Planned Parenthood, who 
has adopted as a strategy the building of mega clinics. When 
markets are declining, you need economies of scale.
    That makes sense to me. In the state of Texas, they have 
built a mega clinic that in 2014 expanded their ability to 
serve women by 1,000.
    But when Wal-Mart comes to town you expect smaller 
businesses to close. The fact that these clinics are closing 
that compete with Planned Parenthood is much more a product of 
market forces than it is by any regulation.
    And, in fact, researchers at Guttmacher have said that they 
cannot explain with certainty what is causing the decline or 
what the impact of these regulations are on that decline.
    It is also important, finally, to note that this 
legislation is based on studies that are predominantly done by 
the abortion industry.
    It would be comparable to trying to pass tobacco regulation 
based on the Tobacco Research Institute, an institute that was 
funded by the industry and that suppressed studies that were 
contrary to its economic interests and its economic desires. 
That is true in this area as well.
    Again, if this committee were interested in women's health, 
truly, they would be passing legislation that would require all 
states to report to the CDC the rate of abortions, the injuries 
from abortions, the age and gestational age of the child.
    They would also require and fund studies done by 
independent researchers.
    Thank you, Madam Chair.
    [The prepared statement of Ms. Collett follows:]
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    Ms. Eshoo. Thank you.
    I now would like to recognize Ms. Northup for your 5 
minutes of testimony, and welcome and thank you again.

                   STATEMENT OF NANCY NORTHUP

    Ms. Northup. Thank you, Chairwoman Eshoo----
    Ms. Eshoo. You want to put on your microphone, please?
    Ms. Northup. Thank you, Chairwoman Eshoo, Ranking Member 
Burgess, and members of the subcommittee for inviting me to 
speak at this important hearing this morning.
    Right now, one of the most basic protections of our 
Constitution--the right to make for ourselves the important 
decisions of our lives--is under attack.
    As you have heard this morning, since 2011 states have 
enacted over 450 laws as part of a coordinated nationwide 
strategy to make it harder and sometimes impossible for women 
to access abortion care.
    Last year in 2019 we saw extreme abortion bans enacted in 
state after state. These attacks come against the backdrop of 
the president's vow to appoint justices to the Supreme Court 
who will overturn Roe v. Wade and judges hostile to 
reproductive rights are being confirmed on our federal, trial, 
and appellate courts.
    Recently, people across the nation have been calling on 
Congress to stand up for women and codify Roe. The Women's 
Health Protection Act is the answer to that call.
    The moment is now to draw the line on the decades of 
assaults on women's rights. My name is Nancy Northup and I am 
president and CEO of the Center for Reproductive Rights. We are 
a nonpartisan nonprofit legal organization working to ensure 
that reproductive rights are protected as fundamental human 
rights around the world.
    Since our founding in 1992, we have litigated hundreds of 
cases in state and federal courts, including in the Supreme 
Court, where we will be back in three weeks.
    I have led the Center for 17 years and I have been an 
abortion rights advocate for far longer than that. Never have I 
been as concerned as I am today about the promise of Roe being 
hollowed out for too many women in this country.
    Forty-seven years ago, the Supreme Court recognized in Roe 
that the right of personal liberty guaranteed in the Fourteenth 
Amendment includes the decision by a woman to end her 
pregnancy.
    As the court would later explain, it is the promise of the 
Constitution that there is a realm of personal liberty that the 
government may not enter. This protective realm is the hallmark 
of a free society.
    It is for each one of us and not the government to decide 
for ourselves the intimate and profound choices of our lives 
that we are hearing about this morning.
    These choices include whether and who we choose to marry, 
whether and when to have children, and how we raise our 
children with our values and our beliefs.
    The commitment of Roe to women is that we too are 
guaranteed the dignity and respect to make the critical 
decisions about our bodies, our health, and our lives.
    That guarantee is being obliterated by the avalanche of 
restrictions that have been designed to make the right to 
abortion unavailable, in fact.
    We are not blocked by court orders. This new wave of 
restrictions are closing clinics, exacerbating inequalities, 
and harming women and their families.
    The 2019 state legislative session marked a new level of 
extremism including nine blatantly unconstitutional bans such 
as the blanket Alabama ban.
    New restrictions are still moving through the legislatures 
as we sit here today. Ninety percent of American counties have 
no abortion providers and six states have but one clinic.
    The impact of these restrictive laws are deeply unequal, 
falling most heavily on people who already experience 
significant systemic barriers to quality healthcare including 
those who are women of color, low income, rural, immigrants, 
LGBTQ, young, and living with disabilities.
    That is why Congress needs to pass the Women's Health 
Protection Act. The bill creates a statutory right for 
healthcare providers to provide care and a corresponding right 
for their patients to receive care free of medically-
unnecessary limitations and bans that single out abortion and 
impede access to services.
    It is a meaningful concrete step to ensuring that Roe is 
real for all women. The Women's Health Protection Act is 
targeted at a specific problem on medically unjustified laws 
and bans. Access is also denied to women in this country for 
other reasons including discriminatory restrictions on 
insurance coverage like the Hyde Amendment.
    Other important abortion access bills, most notably the 
EACH Woman Act, are needed to address this inequality. After so 
many years of chipping away at Roe, multiple efforts are needed 
to restore access to abortion care.
    One in four women in the United States will make the 
decision at some point in her life that ending a pregnancy is 
the right decision for her.
    These are women from all walks of life. They live in every 
state. They live in every one of your congressional districts. 
They are our loved ones, our neighbors, and our colleagues.
    A woman's decision is based on her individual 
circumstances, her health and her life.
    Ms. Eshoo. Ms. Northup, your time has expired. One more 
sentence to wind up.
    Ms. Northup. It is time for Congress to act. I urge these 
members to send the act to the floor.
    Thank you.
    [The prepared statement of Ms. Northup follows:]
    [GRAPHICS NOT AVAILABLE IN TIFF FORMAT]      
    
    Ms. Eshoo. Thank you very much.
    It is a pleasure to recognize Ms. Alvarado. You have 5 
minutes for your testimony. I thank you again for being with 
us.

                  STATEMENT OF HOLLY ALVARADO

    Ms. Alvarado. Thank you, Chairwoman Eshoo and Ranking 
Member Burgess and members of the subcommittee, for inviting me 
to testify today.
    My name is Holly Alvarado and I am here to share my story. 
In 2009, I faced multiple barriers in accessing abortion care 
due to burdensome and medically unnecessary state abortion 
restriction.
    I am here today to show you how important it is that you 
pass the Women's Health Protection Act.
    I served in the United States Air Force from 2006 to 2011 
as a law enforcement officer. I was motivated to serve my 
country as the granddaughter of Mexican immigrants.
    I had seen my family build their American dream and felt 
grateful to this nation. I served honorably, earned the rank of 
staff sergeant, and became an instructor.
    I am proud of my service to this country. In 2009, I was 
given orders for deployment. While preparing for deployment in 
the middle of a Wal-Mart shopping for supplies, vomiting in the 
middle of an aisle, I realized I could be pregnant.
    It felt like I was a fast car going 100 miles per hour and 
then someone hit the brakes. I took the time to think about how 
I was not financially or emotionally in the stage of my life 
where I was ready to continue a pregnancy and raise a child.
    To end my pregnancy, I would need to immediately coordinate 
an appointment, an abortion, approval to take leave from work, 
and find time between all of these things to still continue 
preparing for deployment in two weeks.
    I called Planned Parenthood in North Dakota and learned 
that the closest facility that could perform abortions was in 
Fargo, North Dakota, two hours from me.
    North Dakota only has one abortion clinic, which means 
longer wait times for an appointment. They did not have any 
appointments in the next two weeks before deployment and wasn't 
able to help me.
    I was encouraged to call St. Paul, Minnesota, four hours 
away. I called and scheduled my first and second appointment. 
My first appointment was needed to verify my pregnancy with an 
ultrasound and urinalysis. They gave me information and an 
ultrasound picture.
    I needed to book a second appointment for the procedure 
itself. This was not due to any medical reason and it was 
certainly not my preference.
    Minnesota state laws mandate a 24-hour waiting period 
between the first appointment the day of the procedure, and 
because of the wait times for an appointment at the clinic, I 
would have to wait three days between the appointments. I would 
spend a total of four days in Minnesota without resources.
    Due to Minnesota state law, I would also be required to 
endure scripted counselling including information that 
portrayed abortion as unsafe and a threat to my future 
fertility.
    Only after this could I confirm my appointment for the next 
day.
    I ended the phone call secure in my decision to not 
continue the pregnancy. I did not need or benefit from the 
mandated waiting period, the resulting 600-mile round trip, the 
biased counselling, or the protestors in front of the Planned 
Parenthood.
    It was not a cold or bleak decision on my behalf. Rather, a 
compassionate one for myself and life and potential I wanted in 
my own future.
    On top of all of this, I also faced an enormous financial 
burden. Because of the federal ban on abortion coverage, I was 
unable to use TRICARE as my healthcare insurance.
    The procedure for an abortion is approximately $500. In 
addition to purchasing gear for deployment, needs for gas and 
food for the four-hour 600-mile round trip, I had $16 to my 
name the day I drove back to North Dakota.
    A week and a half later, I would fly to Afghanistan with 
almost no money to my name. The environment in Planned 
Parenthood of Minnesota was compassionate. The clinic provided 
an escort to walk me through a line of shouting protestors 
trying to redirect me to a fake clinic nearby.
    When I finally made it to the exam table, my doctor asked 
me, ``Is this what you want?'' We took a pause together. I 
shared that I never wanted to be pregnant. I never wanted to 
travel to Minnesota.
    I never wanted to jump through all of these hoops to obtain 
an abortion. But I knew that this was a pregnancy I did not 
want to continue and, ultimately, knew this was the right 
decision for my life.
    When the procedure was complete, I felt relief. I was 22 
and knew what now 33-year-old me wanted out of life and her 
future. I was confident that the trajectory of my life was 
changed for the better because I was able to make the best 
decision for myself and my life.
    I was a trusted law enforcement officer charged with 
defending my team and resources, taught federal use of force 
and lethal force. I am a decorated campaign veteran who was 
taught Geneva Conventions, NATO rules of engagement, and 
trusted to be competent in my abilities enough to teach them to 
future airmen.
    Yet, when making a decision over my own life I was not 
trusted to know what was best for myself. Several state laws 
made that very clear to me.
    The decision to continue or end a pregnancy is a healthcare 
decision that cannot be made by one individual for another 
individual.
    I cannot reconcile that our government trusted me to hold 
weapons in protection for our country and serve as a respected 
member of our armed services but could not trust me to make the 
right decision over my own body.
    I have no regrets about my decision to end my pregnancy. I 
was honorably discharged from the military and decorated after 
my tour in Afghanistan.
    I received my education in public health, traveled the 
world, met my partner, and now professionally support families 
making healthcare decisions.
    I am proud of the life I now live.
    Ms. Eshoo. Ms. Alvarado, your time has expired. You need 
to----
    Ms. Alvarado. Thank you, ma'am.
    Ms. Eshoo [continuing]. Finish with a sentence to wrap up.
    Ms. Alvarado. I urge you to pass the Women's Health 
Protection Act so that no one else has to face the barriers 
that I did.
    Thank you.
    [The prepared statement of Ms. Alvarado follows:]
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    Ms. Eshoo. Thank you very much.
    We have concluded the statements of all of our witnesses. 
We thank you again. We are now going to move to member 
questions and I recognize myself for 5 minutes of questions.
    But I first want to start out with a couple of comments to 
some of the comments that have been made by my colleagues--that 
there are no safety codifications in this legislation.
    That simply is not so. As long as the state has evidence to 
show that the restrictions increase women's safety, then the 
regulations would stand.
    So there is a direct correlation between the safety of the 
patient and regulations, and that is very important for each 
one of us. We all expect those standards to apply to us when we 
are--especially in a medical setting.
    In terms of viability, the bill acknowledges that viability 
varies on a case by case basis and that the judgment of a 
viability should be made by a physician--by a physician, not a 
politician--and I just can't emphasize that enough, and it 
upholds the Roe standard of viability.
    I also think it is very important to highlight, to 
underscore, the following. Very little is being said about 
contraception and I don't know anyone on this panel, and I am 
not going to ask, but there are very few here that have 11, 12, 
and 15 children. So something is working somewhere and----
    [Laughter.]
    Ms. Eshoo. It is. And the Guttmacher Institute found that, 
quote, ``The evidence clearly indicates that the more and 
better contraceptive use has been the main factor driving the 
long-term decline in teen pregnancy,'' and there is a 
correlation there between the historic low that has been 
reached after the passage of the Affordable Care Act because, 
of course, there is coverage for contraception.
    So now let me get to my questions with the three minutes 
and 30 seconds that I have. I want to go to Nancy Northup. 
Thank you for you work over so many years.
    Roe v. Wade established the right to an abortion nearly 50 
years ago, as you testified. That's almost a half a century 
ago. Imagine that, a half a century ago.
    But can you speak to the disparities, given what the 450 
laws that have been passed, between a woman living in, say, 
Fort Worth or Fort Wayne, Indiana, what they get to exercise in 
terms of a right and a woman living in my community in Palo 
Alto, California?
    Because I think that these disparities are deep and they're 
wide, and they need to be emphasized. So can you comment on 
that first, please?
    Your microphone.
    Ms. Northup. So the constitutional standard is strong and, 
as you say, almost 50 years that each of us has the 
constitutional right to make this decision pre- viability. But 
the reality is because of restrictions that there are vast 
differences and those differences include the ones that Ms. 
Alvarado testified to about having to make multiple trips, 
having to have scripted un-medically-based information that the 
doctor must give to the patient, the depriving of health 
insurance coverage, which Ms. Alvarado also talked about.
    And so we have a situation in the United States today where 
in a place like California, where there is access to services 
in people's own communities, and other states--the state of 
Louisiana, which is going to be before the Supreme Court in 
three weeks and we are representing the clinic in Shreveport 
there, there is only three clinics left in the state of 
Louisiana--one in New Orleans, one in Baton Rouge, and one in 
Shreveport.
    And if the law were to go into effect, if we are not able 
to win this case in the Supreme Court, Louisiana will be down 
to one clinic, one doctor for the entire state for 1 million 
women.
    Ms. Eshoo. I mean, the record is really very full relative 
to these deep and wide discrepancies. So it's based on zip 
code. It defies what the Supreme Court decided, and if you live 
in any of these states and you're a woman, politicians are 
going to make the decision.
    You have nothing to do with your future. I recognize fully 
that there are those that would and have the right to in our 
country to choose not to undergo an abortion. That is what the 
word choice means. But this is forcing people to do one thing. 
So it wipes out choice.
    Dr. Robinson, can you describe for us--of course, abortion 
care in Alabama is legal. Walk me through or walk us through 
exactly what happens. To say that it is legal, however. What 
comes after that comma of however?
    Dr. Robinson. Despite the fact that abortion care is legal 
in Alabama, we only have three clinics to service the whole 
state. And with that being said, our facility actually services 
patients from five states because of restrictions that have 
closed clinics in the other areas or restricted to gestational 
age.
    So even though there are other areas that have clinics, we 
have patients that have to travel very far to get to us. What 
that means is that women, especially those that come from a 
low-income family who are already struggling to make ends meet 
it may be difficult for them to access care despite the fact 
that there is a facility there in Alabama.
    Ms. Eshoo. Was the penalty of 99 years for doctors passed 
in Alabama and then struck down by a lower court?
    Dr. Robinson. That is correct.
    Ms. Eshoo. Ninety-nine years for a doctor. I mean, it is--
that is enough to take anyone's breath away.
    I am out of time, and I now would like to recognize the--
Dr. Burgess, the ranking member of the subcommittee.
    Mr. Burgess.  And, again, I thank the Chair.
    Just before I start with my questions, I do feel obligated 
to point out that there is a serious illness going on half a 
world away and I do hope this subcommittee, which has the 
primary jurisdiction over health, will take that up seriously 
some point in the near future--we have waited some time for 
that--with a formal hearing, not just a briefing.
    Now, I do want to thank our witnesses for being here today.
    Ms. Eshoo. If I could just say something, Mr. Burgess.
    The subcommittee is certainly not ignoring the coronavirus. 
We have had classified briefings that have been very important.
    We have had open briefings where we have all participated. 
And I feel as up to date on the information as possible and we 
will have a hearing with other stakeholders from outside of the 
administration to advise us.
    But in no way, Dr. Burgess--and I think that you know 
this--are we ignoring this. We have scheduled the end of this 
month the hearing with the secretary of HHS. He was the one 
that wanted to come in and do the briefing. He said, I am the 
one that should be doing it and not anyone else.
    He gave us the date. I said, terrific. I will welcome you. 
We will all welcome you. So to suggest that we are ignoring the 
coronavirus is simply not so.
    Mr. Burgess.  But as you know, a hearing is different from 
a briefing and there is no transcript from a briefing and----
    Ms. Eshoo. We had a hearing with the secretary. I just 
explained to you. He wanted to come.
    Mr. Burgess.  Yes.
    Ms. Eshoo. He said, I am the top person. I am the one that 
wants to do it. So I said yes.
    Mr. Burgess.  I don't want to spend any more--I don't want 
to spend any more time in this debate.
    Ms. Eshoo. Well, I want to respond because it is--you are 
suggesting that we are ignoring it. We are not.
    Mr. Burgess.  I am simply suggesting it is an important 
issue that we need to take up.
    I do want to thank our witnesses for being here today. Ms. 
Alvarado, thank you for your service to the country.
    I know it's a difficult subject and I guess, Ms. Forney and 
Ms. Collett, I would like to ask you. Both of you referenced 
data collection and data reporting.
    How do each of you think that that would make a difference 
if we were to engage in that aggressive data collection and 
data reporting that you both described? Where would that go?
    Ms. Forney. I would say that the key to this is that we 
would have real information. Facts, as opposed to estimations. 
The fact that there are certain states that don't even submit 
their data for the CDC makes it impossible for us to really 
follow the numbers and track injuries and deaths.
    Whenever a woman dies by abortion the underlying cause is 
featured instead of the abortion on the death certificate.
    These things are creating data confusion, if you will. So I 
believe that if we are really interested in caring about women, 
we start with getting good information so we are not using data 
from organizations that have predetermined agendas.
    Ms. Collett. Congressman Burgess, the fact is that to the 
extent there is good data, it is, largely, from European 
countries where they have universal healthcare and that creates 
a database for the investigators that want to look at the 
psychological harms that can arise from abortion, whether they 
were based on a preexisting psychological weakness. They also 
have better data on the correlation between suicide and post-
abortion experience.
    So we don't have a comprehensive healthcare system and I am 
glad we don't, frankly. But we could have comprehensive 
reporting, which we simply do not have in this country.
    Even Stanley Henshaw, the former demographer for Planned 
Parenthood and who worked at Guttmacher, has complained that 
the data that they have is incomplete. Eighty percent of the 
abortions in this country are reported to the CDC. But that 
leaves 20 percent with no reports on them, including the state 
of California.
    Mr. Burgess.  Well, it is just interesting. Yesterday in a 
different subcommittee we had a hearing on self-driving cars. I 
realize that sounds unrelated.
    But the almost universal in all the witnesses that were 
there was the acknowledgment that we needed good data on safety 
and accidents and to be able to legislate around that space was 
it was virtually required to have the information. That's why 
when both of you brought that up this morning it struck me that 
that is something that where I think we would all benefit.
    Ms. Collett, let me just ask you, because so much is made 
on the statement of no restriction prior to viability and the 
age of viability, is that something that was set in court 
decree or has that ever been set it statute, the determination 
of viability?
    Ms. Collett. In fact, the U.S. Supreme Court has addressed 
statutes that attempted to statutorily define the stage of 
viability, and as Dr. Robinson and Ms. Northup testified, the 
court has held that it is an individual physician's decision 
which, based on--you, as a doctor, know that there are certain 
conditions, prenatal conditions, that would affect the 
viability of the pregnancy in general. So that statement 
regarding the standard is correct. But the Supreme Court has 
always upheld the right of states to regulate.
    Early on it was the second trimester for women's health and 
then in the last trimester, of course, to protect the unborn 
life. And now, under Casey, that's not even the standard. The 
standard is does the law create a substantial obstacle to a 
woman's access to abortion.
    Mr. Burgess.  But it just strikes me through the continuum 
of my professional career that level of viability has--Parkland 
Hospital, we were told we had to get a gestation of 33 weeks if 
there is going to be any hope. Twenty-three weeks was my 
individual level, and then we saw at the State of the Union 21 
weeks.
    So it does seem to be changing. Are we able--are we 
technically capable of keeping up with the fact that the actual 
length of gestation is changing for viability?
    Ms. Collett. We are seeing many legislatures examine that 
very question and sometimes it's not simply the duration of 
viability but as well as the weight--the estimate of weight--
which is why ultrasound is so important.
    Mr. Burgess.  Thank you, and I yield back.
    Ms. Eshoo. The gentleman yields back.
    A pleasure to recognize the chairman of the full committee, 
Mr. Pallone, for his 5 minutes of questions.
    Mr. Pallone. Thank you, Madam Chair, and I want to thank 
the witnesses for being here because this hearing is an 
important step towards, or forward I should say, in protecting 
access to abortion and stopping unnecessary state laws that 
intrude on a woman's ability to exercise her constitutionally-
protected right to abortion.
    But I want to focus on the actual bill today and what that 
means for abortion access. So let me start with Ms. Northup.
    Will you discuss why you believe the Women's Health 
Protection Act is necessary and what effect the bill would have 
if it became law? Briefly.
    Ms. Northup. So yes, necessary. Yes, necessary, as we have 
been talking about this morning, the avalanche of laws. And 
what the Women's Health Protection Act does is make sure that 
doctors have a right to provide services free from unnecessary 
regulations and unscientific regulations and women have a right 
to get that care.
    And what it does is both specify the type of medically 
unnecessary laws that are burdensome. So admitting privileges--
like, we are twice up in the Supreme Court fighting about that, 
even though the Supreme Court has decided.
    Waiting periods that aren't medically necessary. The kind 
of hallmark or hallway restrictions and so forth that aren't 
necessary. And that it also provides a broader test for new 
kinds of things that will come up, to make sure that they are 
medically based.
    And the reason why it's necessary, even though we win 
hundreds of cases including the last one in the Supreme Court, 
even after we won that Supreme Court case over a hundred new 
restrictions were passed in the state disregarding the Supreme 
Court's clear guidance that you have to actually advance 
women's health.
    The Supreme Court found that Texas's admitting privileges 
did not advance women's health. But the laws keep coming.
    We need a statute that makes it clear that we are going to 
have fact-based medically-based scientifically-based 
regulations, not these underhanded tactics to shut clinics and 
block women from care.
    Mr. Pallone. Thank you.
    Dr. Robinson, how would the bill change your practice if 
healthcare providers had a statutory right to provide abortion 
services and that your patients would also have a right to 
receive such services? Briefly.
    Dr. Robinson. Well, we know that abortion care needs to be 
safe and it needs to be readily accessible for all patients, 
and these restrictions are making it where it places barriers 
that makes it more difficult for these patients to access the 
care that they need.
    So the Women's Health Protection Act will ensure that 
patients can receive the care they need without constant 
regulations coming down that are constantly chipping away at 
that care.
    Mr. Pallone. All right. Thank you.
    Back to Ms. Northup, and maybe just yes or no, would the 
bill in any way require or mandate that providers provide 
abortion if they did not want to?
    Ms. Northup. No.
    Mr. Pallone. And can you describe how the bill would impact 
the limitations and restrictions that have been placed on 
abortion care at the state level?
    For example, would the requirement that a provider offer 
medically inaccurate information in advance of an abortion be 
allowed to stand? Why don't you just address that since you 
kind of addressed the others before?
    Ms. Northup. No, you cannot--the Women's Health Protection 
Act would stop these laws that require doctors to provide 
medically inaccurate information to women.
    So, for example, right now there are many state laws that 
are requiring doctors to tell women that medication abortion is 
reversible. I mean, that is scientifically untrue.
    The American Medical Association is suing the state of 
North Dakota on behalf of the doctors in that state to say you 
cannot force doctors to tell patients things that aren't true.
    Mr. Pallone. All right. Now, it is my understanding that 
the bill specifically ensures that state laws can be maintained 
if they demonstrate that the requirement significantly advances 
the safety of abortion services or the health of patients. Is 
that correct?
    Ms. Northup. Absolutely.
    Mr. Pallone. Well, given this, is there anything in the 
bill that would make the provision of abortion care less safe? 
Because I know we have heard that from some of the----
    Ms. Northup. Absolutely not, and it has been clear by the 
American Medical Association, including the brief they just 
filed in the Supreme Court. Abortion is a safe procedure.
    Mr. Pallone. OK. I just want to thank you. The bill, in my 
opinion, is critical to ensuring that healthcare providers can 
provide the care they are trained to provide free of 
unnecessary restrictions.
    I always worry about, you know, efforts on the federal 
level, let alone the state level, where we try to tell doctors 
what they should do or not do, even though they are the 
experts.
    And, you know, so I think it is important that patients get 
the care they need and that they are constitutionally entitled 
to, and I am proud to support the bill and I believe it is an 
important legislative solution to protect access to abortion, 
which increasingly is not available.
    And as Dr. Robinson pointed out, it can't be that in New 
Jersey you can get an abortion but in Alabama it's almost 
impossible. So I appreciate all of your statements. Thank you. 
Thank you, Madam Chair.
    Ms. Eshoo. The gentleman yields.
    And it is a pleasure to recognize the gentleman from 
Illinois, Mr. Shimkus, for his 5 minutes of questioning.
    Mr. Shimkus.  Thank you, Madam Chairman.
    Before I start, I just want to congratulate you and my 
colleagues. This is such a tough issue and if we continue to 
deal with this with dignity and respect I think it'll bring 
some luster back onto the legislative branch that we can have 
this tough discussion.
    Let me--we got a lot of diversity in this hearing room. Why 
are we, as individual humans, diverse? What is it that makes us 
different? Anyone know, on the panel? Anyone?
    OK. We all have separate DNA. It is our DNA strand that 
defines who we are and all our differences. Red hair, blond, 
black hair. And when is a separate DNA formed, Dr. Robinson, of 
an individual? I mean, you are a doctor so you should know 
this. When is a separate distinct DNA of an individual formed?
    Dr. Robinson. I don't know that that question has ever been 
posed to me or that I have thought about it so----
    Mr. Shimkus.  OK. Well, let me just say--anyone want to 
answer that question?
    Ms. Collett?
    Ms. Collett. Congressman, Dr. Jerome Lejeune provided 
comprehensive testimony on this point at a trial court level in 
Tennessee. That testimony is available and I would be happy to 
forward it to your office. It is at the moment that the sperm 
and the egg unite.
    Mr. Shimkus.  It is at the moment of conception. Half the 
DNA----
    Ms. Collett. Conception, in the medical literature, has 
changed. So it is at the moment of fertilization. Some medical 
journals use conception to mean implantation.
    Mr. Shimkus.  OK. Thank you for that.
    The point being is that half of the DNA comes from the 
woman, half from the male, and that makes you distinct separate 
entity, and I think that is important.
    When does a child's heart begin to beat on its own inside 
the womb? Anyone know?
    Ms. Forney?
    Ms. Forney. I believe it is 28 days.
    Mr. Shimkus.  Six to seven weeks is what most----
    Ms. Forney. No. I mean I think it is 28 days, which would 
be more like four weeks.
    Mr. Shimkus.  Dr. Robinson?
    Dr. Robinson. I don't know the exact answer to that but I 
know that based off of----
    Mr. Shimkus.  Can you give me a ballpark? Can you give me a 
ballpark? Is six----
    Dr. Robinson. Well, I can tell you what I see in my 
practice. Usually around six weeks I can see cardiac activity 
on an ultrasound.
    Mr. Shimkus.  No, is six--all right. All right. Reclaiming 
my time. Reclaiming my time.
    When does the brain activity of an unborn child start 
occurring? Anyone want to--I think the scientific literature 
says six to seven weeks, maybe even before that.
    Then the age of viability. Twenty-three states identify 
either between 20 weeks or 24 weeks as the age of viability, 
from Mississippi to Pennsylvania.
    The president did have, as was mentioned, a child in the 
gallery who was 21 weeks and six days old who is now a healthy 
two-year-old child. Under this bill, would it be legal to abort 
an unborn baby at 21 weeks?
    Ms. Forney? Just answer--just answer it.
    Ms. Forney. I believe it is because----
    Mr. Shimkus.  OK.
    Ms. Forney [continue]. The whole idea is to remove all 
restrictions. I have not read it----
    Mr. Shimkus.  OK. Let me go to--let me go to Ms. Collett.
    Ms. Collett. Congressman, the bill allows post-viability 
and pre-viability based on--post-viability based on health. 
Pre-viability must be unrestricted. And so yes.
    Mr. Shimkus.  OK. So here is the other concerns and 
troubles I have with--we had a debate on a chemical substance--
per- and polyfluorinated compounds. We tried to address the 
issue of vulnerable populations and we tried to make sure that 
it comported with federal law, which was the Unborn Victims of 
Violence Act.
    We know that it is against the law and you are considered a 
capital criminal crime if you attack a pregnant woman and that 
unborn baby dies. Is that correct?
    Ms. Collett. Congressman, in fact New York revised its law 
so it is no longer an independent crime. It is simply 
considered a----
    Mr. Shimkus.  But public law, which we passed here 108 to 
12, the Unborn Victims of Violence Act identifies the unborn 
child in any part of pregnancy even prior to the age that they 
could live, in essence, outside the womb. Is that correct?
    Ms. Collett. That is correct.
    Mr. Shimkus.  Madam Chairman, thank you. My time has 
expired.
    Ms. Eshoo. The gentleman yields back.
    It is a pleasure to recognize the gentleman from New York, 
Mr. Engel, for his 5 minutes of questions.
    Mr. Engel. Thank you. Thank you, Madam Chair, and thank you 
to all of the witnesses.
    Let me start with Ms. Alvarado. I was--I want to thank you 
for your service, first of all, and I was very moved by the 
fact that, you know, we are--we rely on you to keep us safe but 
we, in some instances, don't want to give you the opportunity 
to do what you feel is right with your own body and I thought 
that your testimony was very heartfelt.
    Ms. Alvarado. Thank you.
    Mr. Engel. The abortion issue has always been an issue that 
both sides take stands and kind of butt heads with each other. 
You know, my third child was born when I was 46 years old and 
my wife was 40. We didn't expect it, and we made a choice to 
have the child.
    But that was our choice. I do think that people have the 
right to make that choice for themselves and people who feel 
that abortion is not something they would consider for moral 
reasons or anything else, then I believe that they need to do 
whatever they feel in their heart.
    I don't believe that they ought to be restricting other 
people who may feel differently and that, to me, is very, very 
important.
    Now, since 2011 we have seen a tide of Republican-
controlled states pass about 450 medically unnecessary 
restrictions that limit access to abortion care and make it 
harder for women to get comprehensive healthcare services.
    Ms. Northup, can you describe how these state laws and 
restrictions limit access to abortion care and what outcomes 
have been in states that have enacted them?
    Ms. Northup. Yes. The outcome of the state restrictions, 
many which are designed to make it very hard to provide 
abortion services, is that clinics do in fact close and when 
clinics close women have to travel farther. They need to take 
time off. They need to sometimes make multiple trips and drive 
hundreds of thousands of miles.
    And an example of this is the state of Texas, which is the 
case we took to the Supreme Court in Whole Women's Health v. 
Hellerstedt.
    Texas passed an admitting privileges law, which is not 
medically justified which the Supreme Court found did not 
advance women's health at all because hospitals within, you 
know, 30 miles of an abortion provider can turn down admitting 
privileges for every reason that they want--economic basis of 
the hospital or that they don't like the provision of abortion 
services and they're not going to give providers privileges, 
and half the clinics in the state of Texas closed. And that was 
the case until we won the Supreme Court case and they could 
never reopen because it had been years of litigation.
    So it's an example of the devastation and when those 
clinics close it's not just abortion services that lost but can 
be family planning services, STI services, and other important 
parts of women's healthcare.
    Mr. Engel. Well, how do states justify these laws when they 
know that so many of these restrictions are designed to limit 
access to what's really a constitutionally protected right?
    Ms. Northup. Well, I think it shows the fact that they are 
pretextual laws. They purport that they're about healthcare but 
it's proved in court case after court case that they are not, 
and again, it is why the American Medical Association and 14 
medical groups have filed a brief in the Supreme Court and the 
case will be argued in three weeks to say that these are--
abortion is a safe procedure and the admitting privilege law in 
Louisiana, just like Texas, doesn't advance women's health.
    Mr. Engel. Well, a number of the state laws and regulations 
you have described have been struck down by the courts and most 
notably in 2016, as you just mentioned, the Supreme Court 
struck down two Texas state laws that required abortion 
providers to have hospital admitting privileges and retrofit 
their clinics as ambulatory surgical centers.
    So could you again tell us why it is critical that we have 
a legislative solution to address state abortion restrictions 
instead of just relying on the courts to ensure that the 
constitutional right to abortion is maintained?
    Ms. Northup. Absolutely. So for those of us who litigate in 
the courts it is like playing whack-a-mole. We win a case and 
the next thing comes up again. After Whole Women's Health more 
than a hundred restrictions have been passed.
    The Women's Health Protection Act would provide statutory 
guidelines that are very clear about what is not permitted and 
also a statutory test that would make sure that courts had to 
follow it.
    Right now, unfortunately some courts are not following the 
Supreme Court's jurisprudence and that is the case in Louisiana 
with the U.S. Court of Appeals for the 5th Circuit, which is 
why we are back in the Supreme Court again on the same issue we 
already won.
    And also we don't want to necessarily rely only on the 
courts. Congress has the authority to protect our 
constitutional rights as well.
    Mr. Engel. Thank you. I know my time is up. Thank you, 
Madam Chair.
    Ms. Eshoo. The gentleman yields back.
    It is a pleasure to recognize the gentleman from Kentucky, 
Mr. Guthrie, for his 5 minutes of questions.
    Mr. Guthrie. Thank you very much.
    When we were having our first child--she's 26 now--almost 
27 years ago we went to--we thought we were going to have twins 
and we thought that it could be twins so we--back then they did 
the ultrasound, and at ten weeks old she was the size of a 
Teddy Graham and if you're not as old as I am I guess about the 
size of a gummy bear.
    She was sucking her thumb and had her own little 
personality and her own--so, I mean, no matter where you are on 
this issue you can't deny these are human beings, I mean, and 
whether you feel they have the right to life or not that is a 
different question, I guess, for some people. But they are 
human beings.
    Well, now my 26-year-old is going to have our first 
grandbaby. When she was 13 or 14 weeks along we went to see the 
ultrasound and our little granddaughter-to-be, hopefully on May 
19th, was sucking her thumb just like her mother and it was 
just amazing.
    It was almost looking at the same picture other than it's 
clearer. And so these are distinct and individuals with their 
own personalities and they require their mothers to come into 
this world and to be life--to get into life.
    And so as we were looking at some of the questions my 
colleague just asked, I was going to ask about so H.R. 2975 
states that women's health is--access to healthcare is reduced 
because of abortion--anti-abortion laws.
    And, Ms. Collett, I mean, if you'd just kind of answer, 
maybe rebut some of the stuff that we just heard. My 
understanding is they have--federal qualified health centers 
are available. Just because a place providing abortion services 
isn't available everywhere doesn't mean women aren't getting 
access to good healthcare.
    Could you comment on what was just said?
    Ms. Collett. Certainly.
    Ms. Northup, I believe, mischaracterized the Hellerstedt 
case. The Texas evidentiary record, in that case, was that 
there were some difficulties in obtaining admitting privileges. 
But they did not have a legislative record, nor did they have 
the disciplinary record of physicians and clinics that exist in 
Louisiana.
    In my written testimony, which I would ask to have 
submitted as part of the record, I actually quote the 5th 
Circuit.
    Ms. Eshoo. All written testimonies are part of the record.
    Ms. Collett. Thank you, Madam Chair.
    I quote Judge Elrod of the 5th Circuit, where she notes 
that there was even a challenge on the part of the abortion 
clinics as to whether the Supreme Court could see the 
evidentiary record because of the overbroad protective order 
that was given at the trial court level.
    Nonetheless, the Louisiana Department of Health has 
multiple findings that clinics had unsanitary conditions that 
physicians were--that were hired were unqualified in the area. 
In one case, they hired an ophthalmologist to perform 
abortions.
    And so the record in the Louisiana case is very, very 
different than the record that was in Hellerstedt. I am very 
optimistic, in fact, that the state of Louisiana will prevail 
in that case. But that is the distinction. As far as access, 
even the Guttmacher Institute has published multiple papers 
showing that regulation is not the primary cause for the 
decline in access.
    They have as late as 2018, said that there are other 
reasons for the decline in the abortion rates that, while it is 
a factor, things like the fact that abortion rates have 
declined by 50 percent.
    Women are making different choices, and when that--when you 
lose 50 percent of your market for services, you are going to 
have clinics close. It is very simple. And as I testified 
earlier, Planned Parenthood has the strategy of mega clinics 
now. One exists in St. Paul near my home. Another exists in 
Houston.
    The newspapers report that they expect to increase their 
patient rate to a thousand more people. That is going to affect 
the smaller clinics. And, as Dr. Robinson herself testified, 
there are times when clinics are located nearby but patients 
choose to go to other clinics for various reasons. Part of that 
might be the reputation of the clinic, in part.
    So the simple fact is that as far as STI treatment, as far 
as prenatal care, that is available from other facilities and 
if you really are worried about women's health, let's deal with 
the fact that over 50 percent of the counties in this country 
do not provide obstetrical care in their hospitals.
    Mr. Guthrie. Well, thanks.
    I also have a question. So the bill before us, H.R. 2975, 
forces states to allow abortion regardless of a patient's 
reasons for seeking an abortion. Does that mean that you can 
have an abortion for any reason--for any reason along with this 
bill, Ms. Collett?
    Ms. Collett. Congressman, that is the state of the law 
currently pre-viability, and even in many states post-
viability. For example, in my home state of Minnesota----
    Mr. Guthrie. So I only have 15. So sex selection would be a 
viable reason?
    Ms. Collett. Sex selection would be permitted, yes, as 
would for racial reasons or for the disabilities of the child.
    Mr. Guthrie. OK. Thank you. I only have five seconds to ask 
another question. So I will yield back. Thank you for your 
answers.
    Ms. Eshoo. The gentleman yields back.
    It is a pleasure to recognize the gentleman from North 
Carolina, Mr. Butterfield, for his 5 minutes of questions.
    Mr. Butterfield. Thank you very much, Madam Chair, for 
yielding time and let me thank the five witnesses for their 
testimony today.
    I know this is an important topic that we all must continue 
to have a conversation about. I spent 30 years in a courtroom, 
15 years as a lawyer, 15 years as a judge and I know that 
people feel very strongly about this subject.
    Years ago I was very conflicted on the whole subject of 
abortion and where I should come down as an American citizen, 
as a human being. But Roe v. Wade seems to be the guiding star. 
That is the law of the land and that is what is guiding me in 
my thinking.
    And so I want to first begin by saying that I am struck 
that the Supreme Court has chosen to consider a case that will 
reevaluate settled law and, once again, throw into the question 
nearly 50 years of precedent. And so that is where I want to go 
this morning.
    Ms. Northup, can, you--before I go to Ms. Northup, let me 
just ask Ms. Collett. We keep straying away from the whole 
conversation about contraception.
    Now, where are you on contraception? Do you support 
contraception as a means of birth control?
    Ms. Collett. Congressman, that question was answered by the 
Supreme Court in the Eisenstadt case as well as----
    Mr. Butterfield. I am talking about--Ms. Collett, where are 
you on contraception?
    Ms. Collett. I am post-menopausal, Congressman, so it is 
really not a relevant question to me.
    [Laughter.]
    Mr. Butterfield. Well, I determine what is relevant and I 
would hope that you would answer the question. But let me--let 
me continue. Time is--time is precious.
    Ms. Northup, can you tell us a little bit about this case 
the Center for Reproductive Rights is currently litigating and 
what your--what the outcome means for abortion jurisprudence in 
this country?
    Ms. Northup. Yes. So as I have testified before, the Center 
for Reproductive Rights won the case of Whole Women's Health v. 
Hellerstadt is against Texas, both striking down its admitting 
privileges law and its requirement that every abortion clinic 
in Texas be an ambulatory surgical center.
    The state of Louisiana, despite that ruling, has persisted 
in insisting that it can have an admitting privileges law and 
that admitting privileges law will have just as devastating 
effects in Louisiana.
    It would close all but one clinic and leave a million women 
in the state of Louisiana to have access to just one abortion 
provider.
    And so the district court agreed that it was 
unconstitutional. It found that it had no medical basis as in 
the Texas case in the Supreme Court and that it would harm 
women.
    The U.S. Court of the 5th Circuit, as we argued in the 
Supreme Court, disregarded both the fact findings of the trial 
court and disregarded the Supreme Court's standard.
    So we are back in the Supreme Court to make sure this law 
doesn't go into effect.
    Mr. Butterfield. You are a 501(c)(3). Is that right? A 
(c)(3)?
    Ms. Northup. Yes, we are. Yes, we are nonprofit.
    Mr. Butterfield. Correct? OK.
    Ms. Northup. That is correct.
    Mr. Butterfield. All right.
    Ms. Northup. I would also like to just straighten out what 
was said by Ms. Collett about the Louisiana case. Louisiana, 
indeed, tried to muddy up the record and put allegations that 
she went through into the record.
    The Supreme Court denied their attempt to do that.
    Mr. Butterfield. Is it fair to say that the major 
difference between the June medical case and the 2016 Whole 
Women's Health decision is that the Supreme Court now has two 
new justices? Would that factor into your opinion?
    Ms. Northup. Well, the only thing that has changed is there 
are two new justices on the Supreme Court. Otherwise, it is 
still not a medically benefiting law. It still harms women. 
That has not changed.
    Mr. Butterfield. Is there any meaningful difference in the 
current case that would warrant a different outcome from the 
court's decision just four years ago?
    Ms. Northup. No. The law that is challenged is identical, 
not similar. It is identical.
    Mr. Butterfield. I fear that the court's decision to hear 
this case less than four years after its decision has 
ramifications not just for abortion access but for the 
impartiality of the entire court system.
    I am disturbed by the implications of injecting ideology 
and distrust into our legal process. I am really concerned 
about that. You know, you and I are lawyers and when we take 
our attorney oath, you know, not only do we swear that we will 
represent our clients zealously but we will protect the 
integrity of the judiciary. We would hold public confidence in 
the court system and I am really--I am disturbed about the 
implications of injecting ideology into the legal process.
    What signal does it send that the court is considering a 
factually identical case less than four years after the earlier 
case?
    Ms. Northup. Well, we did ask for the court to take the 
case because of the 5th Circuit not following their precedent. 
So we are hoping that the Supreme Court, indeed, does follow 
their precedent because otherwise, the floodgates will open to 
even more restrictions. States will know that anything goes.
    Mr. Butterfield. And it will divide this country more than 
anything that we have seen in recent years and I don't want to 
see that happen.
    Thank you, Madam Chair. I yield back.
    Ms. Eshoo. The gentleman yields back.
    A pleasure to recognize the gentleman from Virginia, Mr. 
Griffith, for his 5 minutes of questions.
    Mr. Griffith. Thank you very much.
    Ms. Collett, would H.R. 2975 eliminate state laws requiring 
a person to wait for a period of time between first visiting a 
provider and having an abortion?
    Ms. Collett. It would.
    Mr. Griffith. Would it eliminate state laws requiring 
providers to obtain informed consent before an abortion takes 
place?
    Ms. Collett. It would certainly limit what was required for 
informed consent.
    Mr. Griffith. Would it eliminate state laws requiring 
abortion clinics to meet certain medical standards?
    Ms. Collett. It would.
    Mr. Griffith. Would it eliminate state laws----
    Ms. Collett. I am sorry, Mr. Congressman.
    Mr. Griffith. Yes?
    Ms. Collett. To the extent like in Louisiana where abortion 
clinics are regulated in the same way as ambulatory surgical 
centers, it might allow that since it is a general law.
    Mr. Griffith. Would it eliminate state laws that establish 
certain educational professional standards for those who 
perform abortions?
    Ms. Collett. It could.
    Mr. Griffith. And would it eliminate state laws that have 
created licensing and inspection requirements for abortion 
clinics?
    Ms. Collett. To the extent that they differ from many 
others, yes.
    Mr. Griffith. OK. You know, I asked those questions because 
those are all things that I think are reasonable, particularly 
in many states the 24-hour waiting period.
    And you have an active practice. When I was actively 
practicing, I counselled clients going into a divorce or other 
litigation, all right, here's where--here is where we are at. 
Here is what I would recommend if you choose to go forward. Go 
home and sleep on it.
    That seems to be very reasonable. Do you do the same in 
your practice? Do you think that is a reasonable request, that 
people sleep on it before they make a final decision? Even on 
litigation, we are talking about something much more serious 
than that.
    Ms. Collett. Just for purposes if my dean is reading the 
transcript, I am a full time academic with an active practice 
as well.
    Mr. Griffith. As well. Right.
    Ms. Collett. But yes, when I counsel clients--I started in 
estate planning and when people wanted to file a will contest, 
I would, obviously, say you need to go home and think about 
this and its impact on your family.
    Mr. Griffith. Right. Because an estate fight means that the 
family may never get back together again and that there are 
going to be a lot of hurt feelings.
    Ms. Collett. That is exactly right.
    Mr. Griffith. Here we are talking about a life. It seems 
very reasonable to me. Now, you and Ms. Northup have got a 
battle going on and she made comments earlier to straighten you 
out. Is there anything that you would like to respond to that 
she made in those comments?
    Ms. Collett. Well, I just mentioned that unlike Texas, 
Louisiana's requirements are mirrored in their ambulatory 
surgical center requirements. And so that, too, makes the case 
unique.
    Mr. Griffith. Yes. You know, it is interesting. The 
Virginia legislature this year is changing a lot of our laws 
related to abortion. But the Senate bill that was decided on a 
tie-breaking vote by the lieutenant governor, Justin Fairfax, 
does not eliminate Virginia's requirement for informed written 
consent.
    This bill would impact that possibly?
    Ms. Collett. Again, the general requirement of informed 
consent could possibly be successfully defended. But specific 
types of information that would be required could be struck 
down.
    Mr. Griffith. Now, I am going to ask you this one and I am 
not sure the bill directly deals with it. But I want your 
interpretation of it.
    Last year there was a controversy in Virginia related to 
the time of birth abortion. It came up as a result of the Kathy 
Tran bill.
    Would this bill make the time of birth abortion available?
    Ms. Collett. If I understand that phrase, I suspect it 
comes from the governor's statement that a child would----
    Mr. Griffith. Actually, it came from Tran's testimony. The 
governor went further--went a step further to infanticide. The 
Tran bill actually didn't do that.
    It just said that if there was an emotional reason that a 
single doctor and the mother could decide to abort the baby 
even after contractions had begun and the mother was dilated 
and ready to deliver. Would this bill impact that in any way?
    Ms. Collett. I have not considered that question. But it 
seems likely.
    Mr. Griffith. Would you--would you be kind enough to 
consider it after today's hearing and let me know?
    Ms. Collett. I would be delighted.
    Mr. Griffith. Thank you very much. I appreciate all of your 
testimony. I know this is an emotional issue for everybody. We 
are just trying to do what we think is right.
    And I yield back.
    Ms. Eshoo. The gentleman yields back.
    And it is a real pleasure to recognize the gentlewoman from 
California, Ms. Matsui, for her 5 minutes of questions.
    Ms. Matsui. Thank you very much, Madam Chair, and I want to 
thank the witnesses for being here today on this very important 
discussion that we are having here today.
    First of all, Ms. Northup, I want to following up on the 
previous question. Would you please clarify what you believe 
this bill would and would not do?
    Ms. Northup. Yes. There is nothing in this bill that would 
change anything about the viability standard of the Supreme 
Court and the fact that post-viability--it is up to states to 
decide as long as there is an exception for women's life and 
health.
    So we have heard things this morning that suggest that this 
would do something else. It doesn't change Roe v. Wade in any 
way in that regard.
    What it does is simply say that if there is a regulation 
targeted just at abortion providers that are not medically 
justified, that it doesn't stand, because that is what we have 
been dealing with.
    It is a very precise bill to address the fact that there 
has been this underhanded attempt to shut down clinics, and 
block access to services with these pretextual bills.
    Ms. Matsui. Thank you very much for that clarification.
    I am particularly shocked by state laws compelling mandated 
speech for abortion providers. It is unsettling to me that 
policymakers are requiring doctors to give medically 
inaccurate, misleading counselling sessions before an abortion. 
It is difficult enough.
    Most concerning to me are state laws that mandate the 
inclusion of inaccurate information about mental health 
outcomes such as post-traumatic stress disorder, anxiety, and 
depression, even though the evidence does not demonstrate that 
this is the case.
    The American College of Obstetricians and Gynecologists 
states that laws compelling physicians to provide patients with 
medically inaccurate scripted information are in direct 
violation of physicians' oath of care.
    Dr. Robinson, do you agree?
    Dr. Robinson. Yes, I do.
    Ms. Matsui. In their written statement in support of the 
Women's Health Protection Act, the American College of 
Obstetricians and Gynecologists, ACOG, states that mandating 
medically inaccurate counselling manipulates informed consent, 
an ethical doctrine rooted in the concept of self-determination 
and the belief that patients have a right to make their own 
decisions regarding their health.
    Dr. Robinson, can you describe what it is like for you to 
have to tell your patients, medically inaccurate information?
    Dr. Robinson. Well, with my patients it is already 
difficult for patients to make some healthcare decisions, and 
so complicating that situation and that interaction between me 
and my patients with requiring me to give them misinformation 
makes this even more complicated for the patients to make these 
decisions.
    And then I know that it is difficult for the patient 
sitting there to hear me tell them one thing and then go back 
and tell them medically accurate information but tell them that 
my state requires them to do that.
    And if you don't mind, I just wanted to correct or just to 
go back to this thing that we keep talking about, about 
viability. We talk about the child that President Trump brought 
on the stage a couple of--about a week ago.
    The thing about viability is that is something that varies. 
We can't just put a gestational age on it. I know that he 
brought a child that was allegedly 21 weeks and six days at 
that time. In 15 years of practice, I have never seen a 21-
weeker survive.
    And, you know, as the Healthcare Committee, I think it's 
important for us to keep in mind that our job is to make sure 
that we make healthcare available for everyone and one of those 
things that we have to think about when we are talking about 
viability is the resources of the area.
    If you have hospitals that don't have the resources to 
support a 23- weeker or a 24-weeker; I can't talk about a 21-
weeker--I have never seen that medically happen--then they 
can't take care of--they can't even begin to try to keep these 
children alive.
    The other things about it is that as hospitals are closing, 
there is nowhere for these women to go. So one of the things 
that we can do to ensure health and safety for everybody is, 
like, looking at ways to--for states that didn't take Medicaid 
expansion to do that so that these hospitals aren't closing at 
alarming rates.
    Ms. Matsui. Thank you very much.
    Dr. Robinson, in your professional opinion, is there any 
medical necessity for a mandatory delay between an initial 
counselling session and the follow-up visit for an abortion? 
Yes or no?
    Dr. Robinson. Absolutely not.
    Ms. Matsui. OK.
    Dr. Robinson. These women, when they come into my clinic, 
they have already thought about this long and hard. They put a 
lot of thought into this decision before they come through my 
doors.
    Ms. Matsui. Right.
    Dr. Robinson. And so to require them to wait an additional 
time frame only just puts an undue burden on them.
    Ms. Matsui. OK. Given this, do you believe that the Women's 
Health Protection Act is needed to ensure states cannot 
arbitrarily and unnecessarily restrict access to care?
    Dr. Robinson. Absolutely. My state went from having a 24-
hour waiting period to a 48-hour waiting period. I can tell you 
I have never met a woman in 15 years who felt like the 
counselling that she received from me changed her mind about 
whether she wanted to have an abortion or not.
    Ms. Matsui. Thank you very much, and I yield back.
    Ms. Eshoo. The gentlewoman yields back.
    I now recognize the gentleman from Florida, Mr. Bilirakis, 
for his 5 minutes of questions.
    Mr. Bilirakis.  Thank you, Madam Chair. I appreciate it 
very much.
    In my limited time, I would like to use this time to 
highlight pro-life voices in my district. Where appropriate, 
names have been changed to protect the privacy of the patients.
    I sincerely appreciate the faithful work of our nonprofit 
pregnancy centers like A Woman's Place medical clinic and A New 
Life Solutions and many others in and out of my district in the 
state of Florida, and the courage of my constituents to share 
their personal stories with our committee in order to better 
inform and guide.
    ``Sandy came to us, having experienced multiple abortions 
in her past. She decided to choose life for this pregnancy. As 
a single woman, she needed support. She has been attending our 
Elevate class program during her pregnancy and receiving 
emotional and spiritual support. We also gave Sandy information 
about the Passages of Hope post-abortion recovery program.''
    Next, we have ``Our clinic staff recently met with a young 
college student who was unsure about whether she could be 
pregnant because she had been on birth control. She shared that 
the timing would not be good for being pregnant because of 
school and finances, and she was emotional even discussing how 
she could tell her parents.
    The father of the baby also shared concerns and said he did 
not feel he could be supportive of a decision to have a baby. 
During her sonogram, the client discovered she was very 
advanced in her pregnancy and left planning to find a late-term 
abortion clinic.
    Our clinic staff--these are the pregnancy centers again--
our clinic staff faithfully followed up with this vulnerable 
young woman who eventually chose life for her baby. She and the 
father signed up for classes and have been regularly attending, 
receiving love, encouragement, and support.''
    And I have another constituent. She says, ``I am a pro-life 
woman''--her name is Cindy. In my particular congressional 
district in Florida. ``I found myself pregnant at 16 after a 
challenging childhood. I went to an abortion clinic to have an 
abortion because I wanted to break the cycle of generational 
poverty and abuse in which I have been raised. I didn't think I 
could do that while raising my own child. While in the clinic, 
I was struck by the fact that if my own mother, who had given 
birth to me at 17, had made the choice I was about to make that 
I wouldn't exist. I couldn't go through with it and I left the 
clinic. I thank God for that choice every day. My daughter will 
be 23 this month. She is about to graduate from college and 
will undoubtedly make a profound impact on the world. Having 
her changed my life for the better. I went to college and 
graduate school and I have spent more than 20 years working in 
public service. My child deserved the same choice I deserved--
the chance to live.''
    Then we have Susan. Susan opened up to us and shared that 
she had a history of multiple abortions. She shared her 
circumstances and insecurities surrounding her current 
pregnancy.
    Susan said she was anxious regarding the father of the baby 
not being someone she was in a committed relationship with and 
that it is her son's friend's father.
    She also shared her desire to find connection and that she 
had been feeling very lonely. She agreed to an ultrasound, 
revealing that she was past her first trimester.
    Although feeling overwhelmed, she decided to move forward 
with her pregnancy and enrolled in our Elevate class program 
for support and encouragement.
    Again, I have additional testimonies, Madam Chair, from 
Floridians that, due to time constraints, I was unable to get 
to. However, I ask unanimous consent, Madam Chair, for these 
voices to be included in the record, and I have----
    Ms. Eshoo. We will examine the documents and we will----
    Mr. Bilirakis.  Thank you very much, and I thank the 
witnesses for their testimony.
    Ms. Eshoo. The gentleman yields.
    Pleasure to recognize the gentlewoman from Florida, Ms. 
Castor, for her 5 minutes of questions.
    Ms. Castor.  Thank you, Madam Chair.
    Since we are in the Health Subcommittee, I would like to 
focus on the health impacts of and implications of the--of 
medically unnecessary restrictions on abortion care and how 
they interfere with the important doctor-patient relationship.
    The American College of Obstetricians and Gynecologists 
notes that, like all medical matters, decisions regarding 
reproductive healthcare including, abortion care, should be 
made by patients in consultation with their providers and 
without undue interference by outside parties.
    Like all patients seeking medical care, women seeking 
abortion care are entitled to privacy, dignity, respect, and 
support.
    Dr. Robinson, please discuss the value of the doctor-
patient relationship in the care that you provide. How do 
waiting periods, inaccurate counselling mandates, criminal 
penalties on doctors, and other restrictions on abortion impact 
that doctor-patient relationship?
    Dr. Robinson. Well, the relationship that I have with my 
patients is one of the most intimate relationships that I have. 
A lot of times these patients come to me in critical times 
needing guidance, needing support, and one of the things that I 
can tell you that they don't need is judgment.
    And with some of the regulations that are passed a lot of 
them are aimed at judging the patients, punishing them, and 
also punishing physicians, and this limits care. It limits 
options for patients.
    And as far as providers coming to the community, it also 
weakens the community because it decreases the likelihood of 
other physicians being willing to come and practice in those 
areas, especially hostile areas.
    I am an obstetrician in addition to providing abortion 
care, and I see how this type of legislation is affecting the 
patients that I care for right now.
    I had a patient that was admitted to the hospital. She was 
pre-viable. She was not what has been recognized as the 
standard gestational age for viability, which is about 23 to 24 
weeks. She was not that far along.
    And I saw that there was a physician who was co-managing 
this patient who was pushing this woman, trying to--focusing at 
that time more on the fetus and not on the patient in front of 
them.
    And so this young lady, she actually had pre-eclampsia, 
which is a pregnancy-related condition where her blood pressure 
were really high. She had systolic blood pressure that were 
greater than 200 and diastolic blood pressures that were 
greater than 120.
    We had tried to control her blood pressures with 
medication. But we do know that the only cure for pre-eclampsia 
is delivery. My hospital requires that I get consensus from 
another provider before I can proceed with doing what is best 
for that patient, which was emptying her uterus at that time.
    And I know, as a medical professional, that if I emptied 
her uterus at that gestational age, her baby would not live 
outside of the womb. But that is what was needed.
    And I think that these type of restrictions and the threat 
of penalties to physicians it affects the way we care for 
patients and it further puts women in harm's way.
    And so this is going to add to the mortality--the infant 
mortality rates--maternal mortality rates that we are already 
seeing.
    Ms. Castor.  That is a serious issue in America.
    Ms. Northup, I have taken some notes on some inflammatory 
language here today. Abortion on demand. Unlimited abortions at 
every stage of pregnancy. Late-term abortion clinics.
    That is not how abortion care works, is it? I mean, Roe 
allows for restrictions on post-viability abortions so long as 
they contain adequate exceptions to protect the woman's life 
and health. Isn't that correct?
    Ms. Northup. That is absolutely correct. It is the 
constitutional standard and it is what is in the Women's Health 
Protection Act.
    Ms. Castor.  I mean, for over 50 years Roe v. Wade has 
provided a right to privacy for women and families to make 
personal medical decisions. That was a landmark decision. It 
followed another very important decision that outlawed a--that 
said states cannot prohibit contraceptives--make that illegal. 
And these decisions have been fundamental to the well-being of 
women and families across America.
    Now we are dealing with politicians across the country who 
are mostly older men--let us be honest--in state legislatures 
and here in Congress.
    They are enacting undue burdens on health services and 
contraceptives, and you have the Trump administration that 
wants to take away the protection for preexisting conditions 
and eliminate health coverage, and insurance coverage, that 
covers contraceptives.
    States and some in the GOP have urged that doctors be 
subject to criminal penalties for necessary abortion care, and 
have restricted what doctors can and can't say to their 
patients. That is dangerous.
    It is unsafe and it is wrong, and that is why we need to 
pass the Women's Health Protection Act so these decisions are 
made in consultation with physicians and not politicians.
    Thank you.
    Ms. Eshoo. The gentlewoman yields back.
    I now get to recognize the gentleman from Missouri, Mr. 
Long, for his 5 minutes of questions.
    Mr. Long. Thank you, Madam Chairwoman.
    And I am one of those older gentlemen that Ms. Castor was 
referring to, and the reason I am older is because I graduated 
high school in 1973.
    1973 was when they passed Roe v. Wade, as everyone knows, 
and I didn't understand it then and I don't understand it now. 
I don't make any apologies but to think that you can go in and 
take a human life never registered with me as a high school 
senior, and as an old man, as Ms. Castor calls me now, it still 
doesn't register with me.
    Ms. Forney, I want to thank you for being here today and 
sharing your story and the work of Silent No More awareness 
campaign, which you co-founded.
    As you know, there are close to 20,000 women associated 
with this campaign and many thousands have shared their stories 
about the emotional and physical pain of abortion.
    Can you speak to the common thread in these women's lives 
following their decision to get abortions? What are the 
physical and emotional aspects the women who have reached out 
to you go through?
    Ms. Forney. Yes. Thank you, sir, for asking the question.
    The common thread is that the belief we had when we were 
facing a pregnancy that was unplanned, unwanted, that somehow 
or another that the abortion was going to solve it. The reality 
became after the procedure was done that it generated a trauma 
to us that created emotional and sometimes physical and 
certainly just a sense of unease. A lack of self-worth often is 
a common way that we describe how we feel about ourselves. I 
think a lot of that--and this is just my opinion--but that 
women are--we are designed physically to create life, to 
support life in our uterus and in our wombs. And the idea that 
when we take those lives, it kind of goes against the actual 
nature of how we were created.
    So what the common thread becomes is that sense of regret, 
that sense of realizing that we didn't take the time to think 
about what we were doing and we wish we would have because now 
we look back and we recognize that the abortion didn't fix 
everything as we had hoped it would.
    We can't reset the clock after a pregnancy. We can't go 
back to being un-pregnant. What we are dealing with now are 
women who have taken the lives of their unborn babies in the 
womb.
    And so living with that physical trauma of having an 
abortion happen to your body is physically traumatic. Then 
going through and seeing the emotional side of it--seeing other 
women pregnant, hearing a vacuum cleaner--these all become 
triggers that change how we can move forward.
    So that becomes the common thread. Thank you for asking the 
question.
    Mr. Long. OK. You touched on my other two points there. 
Also going to ask you, you're also part of the Abortion 
Recovery Coalition. Can you tell us what this coalition is and 
what some of the programs are?
    Ms. Forney. Yes. It is really just an informal group of the 
different leaders--Save One, the Deeper Still Ministry, 
Surrendering the Secret, Forgiven and Set Free.
    We were all here in Washington last year for a meeting and 
afterward we got together and we said, gosh, we should keep 
meeting and having opportunities to, you know, get to know each 
other better, get to know best practices of all these different 
ministries.
    And for Silent No More, we take all of those ministries and 
we promote them as the healing resources that women and men and 
families can go to after they have had an abortion.
    So we really just--it is a very informal coalition. There 
is nothing--I mean; there is nothing more than a spreadsheet 
that created, you know, a conference call, a set of conference 
calls that we have named ourselves the Abortion Recovery 
Coalition. But it is that informal and I actually am the one 
who sends out the emails and host the conference calls.
    Mr. Long. OK. Thank you.
    And let me go to Ms. Collett for just one second in my last 
minute that I have here. Federal law and most state laws 
provide protections to individuals and institutions that 
consciously object to performing abortions, especially under 
religious freedom grounds.
    Does this bill maintain protections based on religious 
freedom?
    Ms. Collett. It does not. It specifically refers to the 
restoration of Religious Freedom Act and exempts this law from 
that. So the attack on providers of conscience will be swift 
and brutal.
    Mr. Long. OK, and I had a little more but I am out of time. 
So I yield back. Thank you.
    Ms. Eshoo. The gentleman yields back.
    And I now recognize the gentleman from Maryland, Mr. 
Sarbanes, for his 5 minutes of questions.
    Mr. Sarbanes.  Thank you, Madam Chair. Thanks to the panel. 
Thank you to you, Ms. Alvarado, for your testimony. Very 
powerful testimony, particularly towards the end when you 
talked about how we trust you to protect us when you deploy on 
behalf of the country.
    But yet, some of these obstacles that are being thrown in 
the way of being able to have a safe abortion don't seem to 
trust your judgment to make what is a very deeply personal 
decision and I think you conveyed that it is not one you made 
lightly. You have thought about it and you reached a judgment 
and you made that decision.
    And the law of Roe v. Wade empowers you to make that 
decision. But your right to do that is increasingly imperiled 
by what we are seeing and what Ms. Northup has described.
    And I thought that it might be helpful to have you just 
touch again on the things that--the obstacles you encountered, 
the things that you felt challenged your own judgment in a way 
that was kind of disrespectful.
    And then perhaps, Ms. Northup, you could comment in each 
instance on how we are seeing that kind of roadblock or 
obstacle intensifying around the country. And at least three 
things that I think you touched on, Ms. Alvarado, that maybe 
you could talk about again was just limited accessibility and 
what that presented as a challenge to those services, the 
waiting period requirement and then some of these very sorts of 
customized prescribed counselling or materials that you 
required to review.
    So if you could just speak to that again and then, Ms. 
Northup, to the extent there is time if you could maybe jump in 
and talk about why those sorts of things are an increasing 
problem that we are seeing across the country, which really, I 
think, the sense on the part of many women is that rights that 
they thought were well protected and intact are now threatened 
and that is generating, I think, a high level of anxiety across 
the country. So----
    Ms. Alvarado. Thank you so much.
    I would like to first discuss the 24-hour waiting period. 
There were many 24 hours prior to the mandated 24 waiting 
period that Mr. Griffith described. So there was that prior to 
the actual procedure, two separate appointments.
    Because of healthcare access in North Dakota, there is only 
one clinic, which meant that the two weeks prior to deployment, 
there weren't any open availability appointments for not only 
the first appointment but the second appointment as well.
    This--as a law enforcement officer, these restrictions that 
were put in place made me feel unsafe. I had to travel 600 
miles out of 300 miles out of Grand Forks, North Dakota, to a 
location that I did not know to undergo a process that I did 
not entirely understand or know how expensive it would be, and 
I told no one where I was going. These put me at greater risk. 
These restrictions are dangerous for women and only serve to 
reinforce stigma.
    I was also given scripted counselling, which has nothing to 
do with patient-centered care. It was scripted. It was not 
based on my needs or my body. And then on top of that, I had 
ultrasounds--two separate ultrasounds. Two separate 
appointments. And, again, none of that was patient-centered 
care. Those are obstacles to healthcare because abortion is 
healthcare.
    Ms. Northup. Yes. And so the waiting periods that Ms. 
Alvarado talked about--24-hour waiting for periods--there are 
increasingly even 48 hours, even 72 hours, and they create a 
huge burden of travel on women and increased costs, time off 
from work, having to get childcare and the like.
    She has also talked about the false scripted counselling 
and, again, we have been fighting those from years, false--
doctors falsely having to talk about an untrue link between 
abortion and breast cancer or between abortion and 
psychological issues, and now the new false counselling on 
medication abortion is reversible, which is not true.
    AMA is suing on that in North Dakota, and the forced 
ultrasounds, which are an insult to women. As the 4th Circuit 
Court of Appeals found, it was a First Amendment violation to 
force doctors to perform an ultrasound and talk to the woman 
about the ultrasound against her wishes and needs.
    Mr. Sarbanes.  Thank you very much. I yield back.
    Ms. Eshoo. The gentleman yields back.
    The Chair now recognizes the gentleman from Georgia, Mr. 
Carter, for his 5 minutes of questions.
    Mr. Carter.  Thank you, Madam Chair, and thank all of you 
for being here.
    I want to--I want to talk about an area. Professor Collett, 
I will direct this to you. I don't know if you have ever heard 
of Rincon, Georgia. It is in Effingham County in south Georgia. 
It is in the 1st Congressional District that I have the honor 
and privilege of representing.
    In Rincon, there is the Pregnancy Care Center of Rincon, 
and they offer a number of different services, including a free 
ultrasound to patients who are thinking about having an 
abortion.
    And I had the opportunity and my staff had the opportunity 
to speak to one of the patients there. Her name was Paige, and 
Paige tells the story about how she was totally overwhelmed 
with what was going on.
    She was young, she was confused, and she was pregnant. And 
she visited the Pregnancy Care Center and on the day that her 
abortion was scheduled, and she actually had an ultrasound. 
Paige ended up changing her mind and decided to keep the baby 
and not to have an abortion.
    And I mention this because, you know, this feeling of 
overwhelming uncertainty I think, is certainly something that I 
would imagine happens to a lot of people in this same 
situation.
    So tell me how it is, in your opinion, Professor Collett, 
that a state that requires an ultrasound before someone has an 
abortion that patients have a full understanding of their 
decision. How is that viewed as preventing a woman from 
accessing an abortion?
    Ms. Collett. Thank you, Congressman. I am very pleased to 
have that question because there does seem to be some 
misinformation on that fact.
    According to Contraception Magazine, a pro-reproductive 
rights peer-reviewed publication, over 90 percent of all 
abortion providers provide ultrasounds prior to abortions.
    They do so because, number one, they need to confirm that 
the pregnancy is inter-uterine--that it is not ectopic, which 
is a major threat to women's lives in this country. It is one 
of the causes of maternal mortality.
    Number two, they need to confirm the gestational age 
because the gestational age of the pregnancy will determine 
what an appropriate technique of abortion is.
    For example, medical abortions or abortions using RU486 are 
limited, according to the FDA, for the time period that they 
can be used and in fact, will be unsuccessful if used outside 
that time period in certain instances and is teratogenic, 
meaning it can cause birth defects.
    They also do an ultrasound in order to make sure, and the 
reason--I was just puzzling about why Ms. Alvarado had to have 
two ultrasounds. But it is possible either that she--because 
the North Dakota clinic did one and Minnesota.
    Or the other possibility is that the physician was worried 
about fetal demise. If there has already been fetal demise 
prior to the abortion, then it's simply an evacuation of the 
uterus. And so, in that instance, the emotional response to it 
will feel different.
    So ultrasound is something that any responsible care 
provider would do prior to performance of an abortion. Where 
the dispute typically is whether or not the woman--whether or 
not the view of the ultrasound should be positioned in such a 
way that the woman could see it, whether or not it is in her 
field of vision or not.
    The woman, to my knowledge, under all of these laws, has 
the right to look away. But that is really the question.
    Mr. Carter.  So in your--in your view, this bill that we 
are considering what would it mean to patient safety? I mean, 
when we talk about--when we talk about abortion services and it 
is said that one of the safest medical procedures in the United 
States, yet in your testimony, you question the evidence used 
to back that claim.
    Ms. Collett. That is correct, Congressman.
    Again, I would use the analogy of trying to regulate the 
tobacco industry based on the Tobacco Research Institute. The 
simple fact is in this country the abortion industry controls 
the research, and as the formal editor-in-chief of the New 
England Journal of Medicine, one of the most prestigious 
medical journals in the country, has written in an op-ed 
regarding pharmaceutical research, when you have the industry 
controlling the research a couple of things happens.
    Number one, research that results in negative information 
about the product simply doesn't get published. And number two, 
bias in the design of the research, bias in the selection of 
the question, all of that--bias in the interpretation of the 
results is a problem.
    If we are serious about women's health in this country, we 
need to fund independent, not industry-related, research in 
this area.
    Mr. Carter.  I don't know how anyone could disagree with 
that. I have to adamantly agree with you. You know, it is 
obvious I am pro-life and I feel very strongly about it. My 
constituents are--most of them are that way as well.
    So thank you for your work. Thank you for being here.
    And I yield back.
    Ms. Eshoo. The gentleman yields back.
    I would like to give Ms. Alvarado a minute to respond to 
what Ms. Collett characterized relative to you. Is it--do you 
think that what she said is correct about you and what took 
place? So you have a minute or less to respond to that and I 
think it would be fair for you to do so.
    Ms. Alvarado. Absolutely not. Ms. Collett was incorrect in 
her speculation at my story. Both ultrasounds were done at the 
Planned Parenthood of St. Paul, Minnesota. They were two 
separate. The first one was to verify the pregnancy and give a 
ultrasound picture, which I believe was purely to find out that 
I was pregnant and confirm that, but also an attempt to shame 
the fact that I wanted these services and I think what that law 
is there for to have those two ultrasounds. Not for any medical 
reason, but to reinforce the stigma of my choice.
    Ms. Eshoo. Thank you.
    Mr. Carter.  Professor Collett pointed out that there were 
safety measures in this, that that was--is that not correct?
    Ms. Collett. That is correct, and I also said that I was 
speculating. I was puzzled why she had two ultrasounds prior to 
that.
    Ms. Eshoo. Well, because you were speculating about someone 
else. I think that someone else at the table could clear the 
air on the speculation. That is why I called on Ms. Alvarado. 
So I don't think that that is out of order.
    I now would like to recognize the gentleman from New 
Mexico, Mr. Lujan, for his 5 minutes of testimony.
    Mr. Lujan. Thank you, Madam Chair.
    Last year, a U.S. district court judge in Mississippi ruled 
that Mississippi's laws, quote, ``unequivocally,'' closed 
quote, violated the Fourteenth Amendment and found that the law 
demonstrated that Mississippi was, quote, ``bent on controlling 
women and minorities,'' unquote, and that the state professed 
interest in women's health was nothing more than, quote, 
``gaslighting,'' closed quote.
    Ms. Northup, do you agree and can you describe how abortion 
restrictions disproportionately impact medically underserved 
and minority communities?
    Ms. Northup. Yes, and I will begin by addressing the 
gaslighting comment of the federal district judge. That is what 
we have seen and established in case after case after case, 
that the purported interest of women's health is just a pretext 
for actually making it harder to access abortion services.
    And the reality is that most women in the United States who 
access abortion services are low-income and so the burdens fall 
heavily on them. And it is also the case that it is 
disproportionately women of color who have abortions so these 
restrictions fall more heavily on them.
    And so the people with the hardest structural barriers to 
get good healthcare are the ones that these laws which make it 
harder to get the healthcare are falling on.
    Mr. Lujan. Dr. Robinson, recently Dr. Horvath-Cosper, who 
is now a reproductive health advocacy fellow, said, I quote, 
``If we are having to give people incorrect information and 
then saying well, you know, the state requires me to say this, 
it is not actually true. It undermines the patient's confidence 
in us as providers.''
    I know you touched on this in your testimony. But my 
question for you, Dr. Robinson, is what impact does it have on 
patients when you are required by state law to give them 
medically inaccurate information when some of your patients may 
also be distrustful of the healthcare system?
    Dr. Robinson. One of the biggest impacts is that it further 
pushes this stance that patients have where they feel like they 
are powerless when it comes to their healthcare.
    I mean, I am their physician. I am a healthcare 
professional. They are coming to me for help and advice and 
then I have to sit there and tell them that I have no power 
over what I have to tell them.
    So it puts them and me too in a position where we feel 
powerless. And if you don't mind, I wanted to respond to the 
question about the ultrasounds and mandatory ultrasounds.
    There was a comment by Ms. Collett saying that it's used 
for us to determine gestational age to decide how to--what type 
of procedure the woman needs to have to make sure we rule out 
an ectopic.
    As a medical professional, I have other means of 
determining the gestational age for my patients and I know how 
to do that and do it well. I learned that in my training at 
University of Alabama Birmingham.
    I also have other means of determining whether there is an 
ectopic pregnancy. I can do that by my physical exam. And if I 
am unsure, then I am responsible enough to know how to perform 
an ultrasound and make sure that patient receives that service 
prior to my proceeding.
    And then as far as determining whether there is a 
miscarriage or if there is already a fetal demise, in 
performing that second ultrasound, that is not necessary 
because with a fetal demise or what we would call a 
miscarriage, the patient still needs the same procedure. She is 
still going to need a D&C.
    So that doesn't change anything. The woman is there. She 
wants her uterus emptied. If there is a fetal demise, she needs 
her uterus emptied and I am still going to do it the same way. 
It doesn't change my medical management at all.
    Mr. Lujan. Thank you.
    Look, what seems clear to me is there must be better access 
to healthcare for all Americans, especially the medically 
underserved, not further restricting access.
    And with that, I want to turn it over and yield to Ms. 
Kelly from Illinois. I will tell you, there has been no 
stronger advocate that has been working on maternal mortality 
for people of color.
    Ms. Kelly. Thank you to my colleague and thank you, all the 
witnesses.
    With all due respect to my colleagues that are sharing 
stories about people that regret having abortions, I always 
find it so interesting that we tend to care more about the 
fetus than the adult or our children.
    Because I worked on a maternal mortality bill for three 
years and I could not get one person on the other side of the 
aisle to sign up for it until we made, you know, some changes. 
And the biggest thing that we need--Medicaid expansion, and 
that is according to ACOG--no one has signed up for that.
    So I find it a little hypocritical. And then I won't even 
go to issues around gun violence that; we don't care about 
those kids that are two, three, four, five, and six. But I 
wanted--in your state of Alabama, you rank 45th as far as 
women's health and Louisiana is absolutely one of the worst as 
is Indiana and Georgia.
    So can you talk about the connection between abortion 
restrictions and maternal health?
    Dr. Robinson. Well, it's the same--it is the same patient 
population that has been affected by these abortion 
restrictions that are also affected by these other disparities 
in healthcare.
    We do know that when women can't access healthcare early in 
their pregnancies that they are more likely to have 
complications like preeclampsia.
    They are more likely to have pre-term deliveries, go into 
pre-term labor, and they are not able to access a medical 
professional until they go in labor.
    Because at that point, they can present to the emergency 
room and they can't be turned away because of EMTALA laws. But 
we know that they can--they can benefit from care early on.
    So Medicaid expansion, making it more accessible for women 
to access the health care system before their time of need, 
even prior to pregnancy, will go a long way as far as 
decreasing these maternal and fetal mortality rates.
    Ms. Eshoo. Thank you, Dr. Robinson.
    The gentle--whose time was it? Oh, it was Mr. Lujan's. The 
gentleman yields back. Thank you.
    It is a pleasure to recognize the gentlewoman from Indiana, 
Mrs. Brooks, for her 5 minutes of questions.
    Mrs. Brooks.  Thank you, Madam Chairwoman. And let me thank 
all of the witnesses for being here. I think it is very 
important for everyone to listen to each other, to your 
stories, to your legal perspectives.
    These are issues that this country and my state of Indiana 
has been grappling with for a very long time. I do believe and 
have tremendous faith in physicians and we don't want patients 
to be powerless.
    But in my view, information is power and having more 
information is power, and having--in Indiana I think we have 
some common sense laws that provide those protections both to 
mothers and to the unborn, all while making sure that mothers 
and doctors are well informed on their options and on the 
choices before them.
    In Indiana, doctors do have to provide mothers with basic 
information about alternatives to abortions, including 
adoption, providing assistance about being a mother before 
performing an abortion procedure.
    We don't ban abortions or tell mothers they can't make 
their own choice. But we do require physicians to have the 
responsibility to make sure that people do know they have a 
choice to her than an abortion.
    This bill, H.R. 2975, I believe would restrict the ability 
of states to provide that sort of guidance to healthcare 
providers about these challenging discussions with patients.
    I am also concerned that it would restrict the amount of 
information, which I do believe, again, is power for any 
patient, rules around and Indiana's rules around late-term 
abortions.
    I would like--while Ms. Northup was asked by my colleague 
across the aisle, Ms. Matsui, clarifying what she thought this 
bill would do and would not do, I would ask the other legal 
expert here at the table, Ms. Collett, would you please tell us 
what you believe H.R. 2975 would do and would not do.
    Ms. Collett. I am sorry. Thank you, Congresswoman.
    Based on the evidentiary standard, it establishes a clear 
and convincing standard for the state's responsibility to show 
that in fact, the limitation or requirement significantly 
advances the safety of abortion.
    Given the lack of clear data on many of these things, that 
standard cannot be met. The Supreme Court has recognized clear 
and convincing evidence as the highest standard of evidence 
that we impose for civil matters.
    In addition to that, the definition of significantly 
advances is not defined in the bill itself. But there is a 
direction to the courts to provide the broadest possible 
interpretation of the legislation.
    And so it override--it would override the Hyde Amendment 
and it would override conscience protections that might find 
refuge in state RFRAs.
    It is a bill that would essentially eliminate almost every 
state protection that are afforded women against the 
malpractice or misconduct of others.
    For example, I cite in my written testimony a couple of 
cases where the abortion industry has gone to court to avoid 
informing public officials where a young girl has been the 
subject of statutory rape, had become pregnant, and had an 
abortion in that instance.
    I represented the Kansas district attorneys in a case where 
that was alleged on the part. They argued that the girl had a 
privacy right not to have the public officials--the law 
enforcement officials--know that she was raped.
    Those sorts of laws probably would fall as well.
    Mrs. Brooks.  Can you talk about Indiana law, for instance, 
requiring parental consent for girls under the age of 18. Can 
you explain why--what some of the reasons are why states do put 
parental notification laws in place and why they have been 
found constitutional and would this bill have any impact on 
that, in your opinion?
    Ms. Collett. Those sorts of laws have been found 
constitutional where properly crafted. Many states have 
parental notification rather than parental consent.
    The court has only addressed parental consent in requiring 
a judicial bypass in cases where the girl is mature and well 
informed, or in the alternative, it is not in her best interest 
to inform the parents.
    The reason the court has upheld these laws is because, 
number one, it is the common standard for almost every medical 
procedure that parents are involved in their minor children's 
decisions. So that is an important factor.
    But number two, they also recognize the benefit of the 
parent guiding the child in what the court calls the selection 
of an ethical and competent provider.
    Dr. Gosnell has been referenced earlier. There are cases in 
Louisiana that are part of the record in the case before the 
Supreme Court right now where providers have been operating 
without a license, where their license has already been taken 
from them.
    And so a parent would want to know that and a parent would 
be able to help the girl with that. They have also found that 
the parents have responsibilities to those minors as far as 
support and proposed medical care. That is one of the biggest 
concerns.
    Mrs. Brooks.  Thank you. My time is up. I yield back.
    Ms. Eshoo. The gentlewoman yields back.
    It is a pleasure to recognize the gentleman from 
Massachusetts, Mr. Kennedy, for his 5 minutes of questions.
    Mr. Kennedy. Thank you, Madam Chair. I want to thank our 
witnesses for being here today. I especially want to thank Ms. 
Alvarado for your service to our country that continues today, 
and also for your willingness to share your lived experience 
with all of us.
    Access to abortion enables people to decide when and if 
they want to have children. Limiting or restricting that access 
not only negatively impacts maternal health outcomes, but the 
more restrictions that are in place the worse children's health 
outcomes become.
    These barriers impact education levels for women and 
pregnant people, and their ability to get better jobs, their 
ability to provide for their current children and families, 
their ability to be financially stable and independent.
    When we think about limiting access to healthcare, we need 
to think about the tertiary and unintended consequences that 
may come with it.
    Ms. Alvarado, there is one provider in your state, as you 
testified. Due to the time it took to see that provider, you 
were forced to travel to another state for care. You were 
forced to have a mandatory ultrasound.
    You were forced to wait 24 hours for a procedure even 
though there was no medical rationale as to why. You were 
forced to have biased counselling about options that you were 
probably well aware of before you entered that exam room.
    You were forced to listen to lies about how an abortion is 
dangerous. You faced economic, physical, and emotional hardship 
just to receive access to healthcare as you defended our 
nation.
    Tragically, ma'am, your story is far from unique, because 
in this country, women and pregnant people are forced to be 
seen by a licensed physician, even though another clinician can 
perform an abortion service.
    Many people can pay for abortion--many people pay for an 
abortion out of pocket because insurance is restricted from 
covering it, as you testified.
    The Federal Government is no better. We restrict Medicaid 
from covering abortion services--again, basic healthcare 
restrictions.
    In no other circumstance would any one of these be 
acceptable, let alone all. We put women, pregnant people, and 
their families in harm's way and the repercussions negatively 
impact our emotional, physical, and economic well-being.
    So, ma'am, can you talk a little bit about how important it 
was for your economic security and personal future to access 
the care that you need?
    Ms. Alvarado. Absolutely. Thank you, sir.
    Like you said, a lot of the information that they shared 
with me is information that I already knew. Information is not 
the only power. It is also about having access. Information and 
access are power.
    Before--as soon as I knew I was pregnant, I had to think 
about the financial considerations of my life from that point 
forward and how that would change.
    I had seen so many barriers for women in the military, 
including childcare, continued deployment schedules, duty, and 
other responsibilities.
    At the time that I got pregnant, I was an E-4 making $1,000 
a paycheck and out of that came rent, food, and gas. And then--
--
    Ms. Eshoo. Can you--I didn't hear what you said your 
paycheck was. Can you restate that?
    Ms. Alvarado. My paycheck was $1,000 every two weeks and 
out of that came rent, gas money, and food. And at that time, I 
already knew that I would be making a career outside of the 
military. So there were professional and educational 
aspirations that I had and I knew that having a child and 
raising a child would require so much--something completely 
different than I had planned.
    Mr. Kennedy. Can you talk a little bit about--you mentioned 
this in your testimony but just I will give you about a minute 
and a half left.
    So I want to get you to articulate, if you can, the burden 
and the honor that a nation puts on your shoulders to defend 
our country and the responsibilities you have with it while 
also saying that you are not empowered to make these decisions 
over your own life.
    Ms. Alvarado. Absolutely.
    I think the only word that really encompasses that feeling 
is infuriating. It is highlighting the hypocrisy that here I 
am, in a position to change the lives of so many people in my 
chain of command and lead a 10-man team into a combat zone that 
I was questioned multiple times and had to face multiple 
barriers in accessing healthcare that is so deeply personal to 
me.
    Mr. Kennedy. And, ma'am, do you think there is any logic as 
to why a series of politicians like those of us on the dais 
should be inserted between that decision between you and your 
partner, your family, your doctor?
    Ms. Alvarado. No, sir. In fact, I ask that you continue to 
protect the fact that this is a decision--a deeply moral and 
ethical and personal decision that should be left to a doctor, 
a woman, and the people that she trusts most in her life.
    Mr. Kennedy. Thank you, ma'am. Thank you for your service.
    Ms. Alvarado. Thank you.
    Mr. Kennedy. Yield back.
    Ms. Eshoo. The gentleman yields back.
    Pleasure to recognize the ranking member of the full 
committee from Oregon, Mr. Walden.
    Mr. Walden. Thank you, Madam Chair.
    Professor Collett, Section 4(e)(2) of H.R. 2975 includes a 
list of exceptions, including one which states the bill does 
not apply to, quote, ``insurance or medical assistance coverage 
of abortion services,'' closed quote.
    Now, a legal analysis by the Lozier Institute points out 
that since there is no definition of insurance or medical 
assistance coverage of abortion services, the bill may 
invalidate the Hyde Amendment, at least in certain situations.
    So my question, as you read through that, is would you 
agree with that analysis that that section might invalidate the 
Hyde Amendment?
    Ms. Collett. Congressman, it is quite possible, given the 
broad interpretation and the purposes of the bill that a 
district court would rule that way.
    Mr. Walden. And what other federal laws and policy riders 
do you think could be overturned by this legislation? I know 
you spoke to some, I think, with Mrs. Brooks. But what other 
things would be overturned, you are aware of?
    Ms. Collett. Independent of the insurance aspect? I am 
sorry. I misunderstood the question initially.
    I am concerned that it will overturn things like the 
ultrasound law, like admitting privileges where there is a 
strong evidentiary basis there is in Louisiana, and things like 
requiring physicians to perform abortions.
    There are some states in which you don't even have to be a 
licensed medical professional to perform an abortion.
    Mr. Walden. Say that again.
    Ms. Collett. There are some states in this country where 
you don't even have to be a licensed medical professional to 
perform an abortion.
    It will also overturn--yes, Congressman?
    Mr. Walden. That is amazing. I didn't realize that.
    Ms. Collett. Yes, Congressman. And so there are also some--
it will overturn limitations, possibly on the use of RU486. It 
will overturn certain informational requirements, because 
abortion is, to my knowledge, the only surgery people, with the 
possible exception of vasectomies, that people seek out because 
of poverty, not because of a medical need for that particular 
surgery.
    It would overturn numerous other important safety 
regulations that women are protected by in this instance.
    And, arguably, because of the health exception being 
undefined in the bill, it's possible that post-viability 
abortions would become essentially available at all times. 
Congress has received in the past testimony by abortion 
providers that they believe that a woman who is psychologically 
distressed with her pregnancy has a health condition that would 
justify a post-viability abortion.
    Mr. Walden. And define in layperson's terms post-viability 
abortion.
    Ms. Collett. Post-viability is an abortion that occurs 
where the child could safely be delivered and surrendered for 
adoption. Instead, the abortion provider actually goes forward 
and terminates that child's life.
    Mr. Walden. And how late in the pregnancy can that occur?
    Ms. Collett. As this committee has already heard, the 
standard age right now is accepted in the medical community as 
23 to 24 weeks, although we do have some cases in which 
children before that have successfully survived.
    Mr. Walden. Right. Right.
    And do you know off the top of your head what states don't 
require licensed medical providers to provide abortion?
    Ms. Collett. Vermont is an example, I believe, your Honor.
    Mr. Walden. OK. Thank you.
    Ms. Collett. I am sorry. Congressman.
    Mr. Walden. Yeah. We are not judges up here.
    Ms. Collett. I am used to courts.
    Mr. Walden. Yes. Thank you.
    Ms. Forney, in your testimony, you mentioned a Planned 
Parenthood Clinic in St. Louis that had its license revoked due 
to safety concerns. Can you elaborate on that? Why was it's 
licence revoked?
    Ms. Forney. There were----
    Mr. Walden. Please turn on your mic, if you would. Thank 
you.
    Ms. Forney. There were 75 medical emergencies that were 
documented at the RHS Planned Parenthood abortion facility 
since--and then, there was a new facility that opened across 
the river in Illinois and in October of 2019, a similar--
another incident occurred.
    The facility in Missouri has had numerous visits by 
ambulances taking patients out. I was there a couple of years 
ago, just on a Saturday morning, praying with some folks, and 
we had an ambulance show up.
    I was shocked. I had never seen an ambulance at an abortion 
clinic, and the normalness with which it was treated was very 
concerning.
    Mr. Walden. Can you speak to the specific safety issues 
that were identified that caused the license revocation?
    Ms. Forney. Well, in the specific issues related to the 
license being revoked, had to do with four women--you know, 
four individual women specifically that each experienced a 
major complication and that is what brought this to the 
attention of the state authorities.
    Mr. Walden. All right. My time has expired. Thank you all 
for your testimony and, Madam Chair, I yield back.
    Ms. Eshoo. The gentleman yields back.
    It is now--let's see, who is next here? The Chair 
recognizes the gentleman from California, Mr. Cardenas, for his 
5 minutes of questions.
    Mr. Cardenas.  Thank you very much, Madam Chairwoman Eshoo, 
and thank you also to Ranking Member Burgess for having this 
important hearing today in the Health Subcommittee.
    I think it is so important for us to understand that 
listening to the impacts of these unfair and unnecessary and 
stigmatizing restrictions on women across our country is very 
important for us to discuss and for the American people to 
hear.
    My daughter, Alina, happens to be with me today and she 
reminds me that nothing is more personal than choices about 
family, including how and when to have one. That is true, no 
matter your zip code or the number on your bank account.
    I have been blessed with an amazing family and, at the same 
time, I have never had to experience a pregnancy, me 
personally, or any other complications or any other matters 
that a human being has to go through to have a pregnancy.
    I have never had to worry about becoming pregnant or face 
the health implications as a result of that. As a man, my 
healthcare is not picked apart and politicized because of 
judgments that lawmakers have about my personal circumstances 
or decisions.
    This is one of the many reasons that it is so important to 
listen to women, to truly hear their experiences, to follow 
their leadership on all of these issues. All the men in the 
world need to speak less and listen more.
    I am a proud co-sponsor of the Women's Health Protection 
Act and I am so grateful for the leadership of Chairwoman Eshoo 
and all the other members who have signed on.
    I have a question to Ms. Northup. Ms. Northup, are you 
aware of any laws in our country in the United States of 
America that requires a man to sleep on it or to think twice 
about a medical procedure that they choose to take? 
Specifically to men.
    Ms. Northup. I am not aware of any such laws.
    Mr. Cardenas.  OK. Neither am I, and I have asked some of 
my colleagues who are very involved in many issues and they 
just shake their heads and say no, a matter of fact, I am not 
aware of one.
    But yet, here we are, speaking about laws across the 
country and legislatures across the country that, in my 
opinion, have proven over and over and over to violate the law 
of the land and the Constitution of the United States.
    At this time, I would like to yield the balance of my time 
to my esteemed colleague, Ms.--Congresswoman Schakowsky.
    Ms. Schakowsky. Thank you so much for yielding.
    Ms. Collett, I just have to say how much I resent when you 
say if you really wanted to care about women, you would do 
something about prenatal care or you would do something about 
maternal mortality.
    The women, on this side of the aisle anyway, have been 
working so hard to do exactly that and the implication is very 
offensive to me that somehow we are blocking addressing these 
issues.
    And the idea of abortion--the abortion industry is 
controlling the data--abortion industry. Do you mean like ACOG, 
the American of--what is it exactly, Dr. Robinson? ACOG?
    Dr. Robinson. American College of Obstetricians and 
Gynecologists.
    Ms. Schakowsky. Yes. That industry, and they support this 
legislation. I want to talk to you, Dr.--
    Ms. Collett. May I respond, please?
    Ms. Schakowsky. No. No. I am not asking a question. I am 
telling you how you make me feel with the kind of testimony you 
have given.
    So I just want to say to Dr. Robinson, so your home state 
of Alabama is openly hostile to abortion. You said that you 
have to give false information--false information. How do you 
get around--so then do you say but the truth is? How do you 
deal with that?
    Dr. Robinson. Well, I basically waste my time and my 
patients' time to give them the information that the state 
requires that I give them, and then I go back and tell them 
true medical facts based off of my training and experience.
    And there is no--there is this concern expressed around if 
this Women's Health Protection Act is passed that patients 
won't get informed consent. We are trained as medical 
professionals to give patients that anyway. We don't need 
politicians to tell us or to dictate exactly what is told to a 
patient in the room.
    As an abortion care provider, I can tell you without a fact 
I am not ashamed of any of the care that I provide and I am not 
scared to tell my patients the facts about the services that 
they are there to receive.
    And these patients are under a delusion about what service 
they are there to----
    Ms. Schakowsky. Let me just ask you one more question, 
though. Are you in danger? We have heard about people who 
provide care, including abortions being under attack and even 
worried about their physical danger.
    Dr. Robinson. Absolutely. My physical person is in danger 
at times and also my financial stability in my community, 
because my hospital sometimes will make it difficult for me to 
remain in the hospital and maintain hospital admitting 
privileges because sometimes they just may be opposed to having 
an abortion provider on their staff. But they are harassed and 
the facility is picketed.
    And as far as my physical person, yes, I am in danger. When 
they talk about abortion providers----
    Ms. Eshoo. Ms. Robinson, the gentlewoman's time has 
expired, and I always hate to cut people off but I have been 
generous on both sides of the aisle and witnesses from both 
parts of the--both sides of the issues that we are discussing 
today.
    It is now a pleasure to recognize the gentleman from 
Montana, Mr. Gianforte, for his 5 minutes of questions.
    Mr. Gianforte. Thank you, Chair.
    While my colleagues on the other side of the aisle seek to 
further undermine the rights of the unborn with this 
legislation, I want to tell a story about a young woman from 
Montana and her beautiful baby boy.
    For the sake of this story, we won't use her real name. 
Instead, I will call her Amy. When Amy was in her early 20s, 
she took a home pregnancy test. When the result proves 
positive, she thinks long and hard about her options.
    Amy is a kind-hearted woman who, in her own words, wouldn't 
hurt a soul but is now weighing abortion as an option. Afraid 
of the unknown, her reasons for considering an abortion grow.
    The next day Amy walks into a clinic to get another 
pregnancy test to verify the result the night before. The 
results are confirmed and an ultrasound indeed shows that she 
is carrying a six-week-old child.
    The fears from the night before resurface. Through her 
tears, she asks the nurse, what am I supposed to do, as the 
weight of the decision comes crashing down on her.
    Comforting her, the nurse says, just give it 24 hours. 
Don't make any final decisions for at least a day. Amy waits a 
day. Then she waits for another. Twelve days later she 
schedules another ultrasound and signs up for parenting 
classes.
    She decided to keep the baby. The advice to be patient that 
that nurse gave allowed Amy the time she needed to realize her 
fears were just that. Only fears.
    For her birthday on May 20th, 2019, Amy gets what she will 
tell you is her greatest birthday gift ever--a happy and 
healthy baby boy. Amy's story is one of hope in the face of 
fear that acts as an inspiration for all of us. If it weren't 
for the nurse who counselled patients, it is a story would have 
ended very differently.
    It is stories about nurses and clinics like this that I 
would like to hear more about from our esteemed witness, Teresa 
Stanton Collett.
    Professor Collett, H.R. 2975 states that pro-life laws, 
quote, ``Harm women's health by reducing access to other 
essential healthcare services.''
    My question for you is what options besides Planned 
Parenthood are there for women seeking comprehensive health 
care services?
    Ms. Collett. There are multiple resources, including some 
that are federally funded. So during the debate, I believe over 
the contraceptive mandate in courts, since that was actually a 
regulation of an agency rather than a congressionally mandated 
situation, it was established that contraception is readily 
available to women throughout the country. I think at the time 
the cost of the pill was $10 and something at Wal-Mart.
    So, first, you have all sorts of general clinics that will 
provide that, increasingly even some of the doctors at some of 
the new models like Urgent Care are providing that sort of 
contraception access.
    Sexually-transmitted diseases, also that testing is 
available. Usually the Department of Health in a state will 
have some clinics that are available to people as well.
    Mr. Gianforte. OK. So suffice it to say women have options 
beyond Planned Parenthood?
    Ms. Collett. They absolutely do, and better options.
    Mr. Gianforte. OK. And why would you say they are better 
options?
    Ms. Collett. Because Planned Parenthood, although it does 
report that a few of its locations offer adoption services, the 
actual numbers that are revealed in their annual report show 
that that is not an option that they actually proceed with, nor 
do they provide prenatal care beyond the most basic during the 
first trimester, whereas many of these other clinics will 
provide obstetric care throughout the pregnancy as well.
    Mr. Gianforte. OK. In the last series of questions, my 
colleague, Ms. Schakowsky, addressed some comments to you. Is 
there anything you would like to say in response?
    Ms. Collett. Certainly. The American College of 
Obstetricians and Gynecologists has never taken a position 
against abortion or recommended any regulation.
    There is a brief that has been filed in the Louisiana case 
that specifically gives the history of how the American College 
of Obstetricians has become politicized on this particular 
issue.
    Mr. Gianforte. Ok. Thank you for your testimony.
    With that, I yield back.
    Ms. Eshoo. The gentleman yields back.
    It is a pleasure to recognize the patient gentlewoman from 
Michigan, Mrs. Dingell, for her 5 minutes of questions.
    Mrs. Dingell. Thank you, Madam Chair.
    I sort of have two different ways that I want to go because 
I want to talk to Ms. Alvarado. We all--I want to say that this 
is a deeply personal issue for every woman and we have seen and 
heard that today from the advocates, the providers, and the 
woman.
    I am somebody that believes that these decisions are best 
made by the individual woman and her doctor. We owe each woman 
to treat them with trust and with dignity and uphold that 
principle.
    Having said this, Ms. Alvarado, we all thank you for your 
service, no matter--I think there is nobody at this table that 
isn't grateful, and I am looking at the pain in your face today 
and I know how hard it has been for you to come and testify.
    But before I get to you, I am going to do two things you 
are never supposed to do. First of all, I am just going to 
gooff-script.
    Ms. Collett, and I appreciate--I know everybody here cares 
deeply. So but when you say that this procedure is the only one 
that you know someone gets because of poverty, last week I was 
with a 24- year-old woman who had been diagnosed with breast 
cancer and chose to have a double mastectomy because she 
couldn't afford her chemotherapy.
    So I think what too many people don't understand is that 
the number of women that have no option. In parts of my state, 
the only--Flint, by the way, being one of them, the only place 
women, who have no desire--the just need healthcare--the only 
place they can go is Planned Parenthood.
    Ms. Northup, I heard you listening carefully to what she 
said. Is there anything you would want to add?
    Ms. Northup. Well, I would like to respond to the 
characterization of this bill, which I think that Ms. Collett 
has not properly characterized, and again, I appreciate that we 
differ here about whether or not abortion should be safe and 
legal and a woman's decision.
    But what I don't appreciate is mischaracterizing. I have 
been doing this for 17 years leading the Center, and over and 
over again, we are trying to, you know, use these proxy fights.
    This bill is very targeted at the problem of unjustified 
medical burdens on clinics and patients that are not justified 
by medicines and science.
    It does not up-end the Hyde Amendment. The Hyde Amendment 
is an unfair restriction on low-income women's access. There is 
a bill, the Each Woman Act, which importantly addresses that.
    This bill clearly excludes in its language and that 
language is not tricky. It is very clear that it's not just 
Hyde. It's any kind of insurance that doesn't cover it.
    It was also suggested that doctors are going to have to 
provide abortions and that the objections that doctors can now 
make because they don't want to provide would be up-ended.
    That is not what this bill does. It has also been suggested 
that it is going to allow abortions at times that Roe v. Wade 
doesn't allow abortions. That is not what this bill does. It 
adopts the Roe standard. It is very targeted to address a 
problem at this moment, which is 450 laws, that are shutting 
clinics, and blocking women's access.
    And I just think it's important to debate what this bill 
does and not to confuse it with things that aren't true.
    Mrs. Dingell. Thank you.
    Ms. Alvarado, thank you again for your courage, and I am 
going to have many questions. But because I wanted you to talk 
about your personal experience and--but I want to ask you this.
    Ms. Collett states in her testimony that there is little, 
if any link to reproductive healthcare access in a woman's 
economic well-being. Do you think--feel that this is accurate, 
given your life experience?
    Ms. Alvarado. No. I am able to live the life that I live 
now because of the decisions that I made at 22. The access--I 
am sorry. How do I say this? I had to travel outside of my 
state with balancing many restrictions and trying to pass those 
in order to make a safe healthcare decision for myself and that 
decision has now led me to a life that I live now. I was able 
to complete an education, working in a beautiful career and 
meet my partner, and that was all because I was able to make a 
safe decision for myself.
    Mrs. Dingell. What would you say to the state legislators 
that are passing these laws, from your own personal experience?
    Ms. Alvarado. That their philosophical beliefs and these 
restrictions that they impose on women are not for the women at 
all. These are only obstacles tohealthcare and women deserve to 
make the best choice for themselves.
    Mrs. Dingell. I yield back, Madam Chair.
    Ms. Eshoo. The gentlewoman yields back.
    I now would like to recognize the gentlewoman from--that is 
not right. Do we have----
    Mr. Duncan. That would be South Carolina, ma'am.
    Ms. Eshoo. Well, let me just note that we have I think just 
one member left here that is waiving onto the committee. But 
because you are not a member of the subcommittee, we need to 
take all the subcommittee members before you, and then I would 
be glad to recognize you, Mr. Duncan.
    So the gentlewoman from Illinois, Ms. Kelly, is recognized 
for her 5 minutes of questions.
    Ms. Kelly. Thank you again to the witnesses for being here 
today.
    Due to restrictions on access to abortion care; many women 
must travel long distances, further delaying the access, as we 
have heard today, to care and increasing their risks to their 
health.
    As various states seek to decrease access to care by 
implementing harmful restrictions, many women must cross state 
lines to places like, where I live in Illinois, to receive 
care.
    It should not be difficult for women to have access to the 
constitutional care they need and are entitled to, and I am 
proud that my state has trusted women to make these decisions 
for themselves.
    I want to talk about the implications of abortion access on 
women's long-term health. When access to abortion is 
restricted, we know there are negative health outcomes that can 
result, harming communities who already face the most 
challenges to accessing care, as we have heard already.
    A groundbreaking study from the University of California 
San Francisco found that women who are turned away from 
accessing abortion and forced to carry an unwanted pregnancy to 
term are almost four times more likely to live below the 
federal poverty line.
    Ms. Northup, are you familiar with this study?
    Ms. Northup. The study from USC? Yes.
    Ms. Kelly. Can you describe the findings of the study and 
what it means for women's long-term health outcomes?
    Ms. Northup. Yes, and we have cited this in our submitted 
testimony, that the study that looked at women who were turned 
away, who were unable to access abortion care that they had 
higher incidence of being in poverty, that they had higher 
challenges with meeting their basic needs in terms of housing 
and other economic needs, and that they did not have--that 
overall when they looked at women turned away or not turned 
away the issue about psychological health was not impacted on 
the women who were able to access.
    Ms. Kelly. And also, it is my understanding that women who 
were unable to terminate unwanted pregnancies would stay with 
violent partners longer, putting them and their children at 
greater risk.
    Ms. Northup. That is right. It was a very important finding 
of the study that women were more likely if they were turned 
away to stay with violent partners.
    Ms. Kelly. And we just discussed the impact on economic 
security and I, again, want to thank you for sharing your story 
with us and you, Ms. Forney, for sharing your story, and Dr. 
Robinson for sharing your story. I know it is not easy, and I 
want to say something about myself that I am a pro-choice 
person that is pro-life. You know, the thing that either you 
are, you know, pro-life or pro-choice, I am pro-life but I 
believe in choice.
    Thank you. I yield back.
    Ms. Eshoo. The gentlewoman yields the remainder of her time 
to me. I appreciate it.
    I think it is very important to set down--first of all, to 
Congresswoman Kelly, the UCSF study I raised in my opening 
statement and it is wonderful that you highlighted it and 
underscored it again because it contains very important 
information.
    I think it's important to set this--the following down as 
part of the record here. Studies show that contraceptive access 
is responsible for one-third of total wage gain women have made 
since the 1960s, and while I found your response, Ms. Collett, 
to, I believe, Mr. Butterfield asking you if you believed in 
contraception and it was interesting for you to share with us 
that you are post-menstrual you didn't answer the question.
    Contraception is one of the answers to what is problematic 
in our country, and there is an entire movement against 
contraception. There is.
    When the Republicans were in control many years ago, they 
removed with a House vote contraception coverage in the 
healthcare coverage that members of Congress had. It was 
corrected later on.
    So I think it's very important to put that on the record. 
And reproductive choice is vital for women to have economic 
freedom. It's a choice that they make. It is not forcing them 
to do one thing. They have a choice. It can be a spiritually in 
the lane of spirituality. It can be many things. But it is a 
choice.
    And so the whole issue, I think, that has been--some of our 
witnesses refuse to talk about contraception. But I think that 
it is really in the center of this discussion and this debate.
    I now would like to recognize the gentleman from 
California, Mr.--Dr. Ruiz, for his 5 minutes of questions.
    Mr. Ruiz. Thank you very much.
    A 2019 article in the Journal of Obstetrics and Gynecology 
described the consensus guidelines for obstetric and 
gynecological care in the United States and brought together a 
broad group of clinicians, consumers, and representatives from 
accrediting bodies to review the available evidence in clinical 
practices to develop and evidence-informed policy.
    The report concluded that, quote, ``Requiring facilities 
that perform office-based procedures including abortion to meet 
standards beyond those currently in effect in all general 
medicine offices and clinics is unjustified based on this 
thorough review and analysis of available evidence,'' unquote.
    I would like to request unanimous consent to submit this 
article for the record.
    [The information appears at the conclusion of the hearing.]
    Mr. Ruiz. Indeed, the authors noted that, quote, ``False 
concerns for patient safety are being used as a justification 
for promoting regulations that specifically target abortion,'' 
unquote, and that, quote, ``Targeting specific procedures based 
on ideology rather than evidence sets a dangerous precedent for 
the regulation of medicine,'' unquote.
    Dr. Robinson, are you familiar with this article?
    Dr. Robinson. Yes.
    Mr. Ruiz. It seems clear to me that the restrictions on 
abortion care placed by some states, presumably under the label 
of, quote, ``safety'' are not actually based on evidence or 
clinical guidelines. Would you agree?
    Dr. Robinson. I agree. That is correct.
    Mr. Ruiz. OK. What precedent does it set for medical 
standards not based on any evidence or clinical care guidelines 
to be imposed on medical procedures?
    Dr. Robinson. Well, one of the things that we do see is 
that it reduces options for patients. It sets a standard where 
me, for instance, as an obstetrician-gynecologist I can't offer 
all options to my patients because it is being restricted 
according to political interference.
    Mr. Ruiz. And so you agree with the journal authors that 
this sets a dangerous precedent for the regulation of medicine?
    Dr. Robinson. It does.
    Mr. Ruiz. How does that influence outcomes in patient care?
    Dr. Robinson. Well, if politicians' are--regulations like 
this are dictating what we can do as providers, then it puts 
patients' health at risk.
     It takes options that are viable options that are really 
pertinent for our patients' healthcare--it takes them off the 
table.
    I talked earlier about one of the patients that I took care 
of in the hospital who, because of these regulations, abortion 
care is very restricted in our hospital.
    A patient who needed to have an abortion and sometimes 
these patients they present to our outpatient clinics but they 
really need inpatient care. I don't have that option, and these 
regulations only make it--only limit it more.
    Mr. Ruiz. According to the authors of this Journal article, 
the panel of medical experts found that abortion procedures 
should be treated the same as comparable medical procedures in 
primary care and gynecology based on medical evidence and 
expert-driven clinical guidelines.
    It's what we do in medicine. I am a doctor. You know, you 
have your peers review what is best in terms of evidence, given 
the experts' recommendations to produce these guidelines.
    Do you agree and, if so, can you discuss with the committee 
why you feel this way that abortion procedures should be 
treated the same as comparable medical procedures in primary 
care and gynecology, based on those--that evidence?
    Dr. Robinson. I think the best way to highlight that is to 
look at some of the examples that we talked about today. 
Because we are not treating abortion and contraception in the 
same way that we are treating other areas of medicine, we are 
seeing clinics close--for instance, Planned Parenthood clinics 
that serve a lot of patients that do more than must abortion 
care.
    They provide contraception. Many women go there for just 
their preventative health services, and because of the way we 
look at abortion and contraceptive care here, we have Planned 
Parenthood clinics that can no longer take care of patients 
that receive state funding like Medicaid funding.
    And I know that Ms. Collett, she mentioned that you have 
federally qualified health centers and urgent cares that can 
see these patients. The one thing about it is a lot of these 
centers are not looking at the patient populations that centers 
like Planned Parenthood are serving.
    There is a lot of urgent cares in my area that will not see 
a patient on Medicaid. So if you have commercial insurance, you 
can go. Or if you are paying cash, you can go.
    But those patients who are already financially 
underprivileged, they don't have the option to just go there 
and pay cash. And urgent cares, a lot of them don't take 
Medicaid.
    So the reality--what you are talking about is not the 
reality in real communities. And so this legislation is hurting 
real patients.
    Mr. Ruiz. Thank you.
    Dr. Robinson. Those patients who would previously be served 
by a Planned Parenthood location.
    Mr. Ruiz. Thank you for your work. A medical decision 
should be made on the basis of science and evidence, not on the 
basis of politics and ideology.
    That is why I support the Women's Health Protection Act and 
urge my colleagues to do so as well.
    Ms. Eshoo. I thank the gentleman. His time has expired.
    Mr. Ruiz. If I may, just to submit this for unanimous 
consent for the record.
    Ms. Eshoo. We have that for the record.
     Mr. Ruiz. Thank you.
    Ms. Eshoo. Thank you.
    The Chair recognizes the gentlewoman from California, Ms. 
Barragan, for her 5 minutes of questions.
    Ms. Barragan. Thank you.
    I want to thank the panel for being here.
    Ms. Alvarado, I want to thank you for sharing your very 
personal story with us, for your testimony. That was just very 
moving. This issue is very personal.
    I am the youngest of 11 kids, and when I was very young my 
sister--one of my sisters got pregnant at 15 and my other 
sister got pregnant at 16.
    And my third sister also got pregnant at a very young age. 
And two of my sisters, one at 15 and one at 16, made a very 
personal decision to give birth.
    My third sister made a very personal decision that it 
wasn't time for her and she wasn't ready. And it was an 
important life decision that all three of my sisters made. And 
if I talk to them, they will tell you how grateful they are to 
have the ability to make a choice.
    And so you coming forward today and sharing your story is 
not easy, because when I have had this conversation with my 
sisters, they have told me that it wasn't easy.
    And so having you here today means a lot because I believe 
it is important that other women, regardless of age, but 
especially our young people, hear from people like you, and I 
just want to give you an opportunity if there is anything that 
you want to add based on your own personal experience or 
perspective to emphasize why it is important that we hear from 
people like you and people like my sisters. I talk about the 
issue of reproductive healthcare and the importance of having a 
choice.
    Ms. Alvarado. Thank you so much for sharing as well.
    If I could just address that my story of no regret and the 
story that Ms. Forney shared of regret, they live in the same 
world. They co-exist. And I am only sorry that those 
individuals that regret their abortion were not empowered to 
make the best choice for themselves.
    And at the heart of that is choice. Of the women that do 
have an abortion, 95 percent of those women do not regret their 
abortion and I am part of that majority.
    And I think that the only way moving forward is to trust 
and empower women by giving them access without restrictions.
    Ms. Barragan. Right. Well, thank you.
    I also, like Dr. Robinson, want to thank you for bringing 
up Planned Parenthood and clinics that are just so critically 
important, especially in communities like mine.
    I represent a district in south Los Angeles that includes 
areas like Compton and Watts. There are only four districts 
that are poorer in California than my district, and when I was 
a child after seeing my three sisters go through what they went 
through, I decided that I would have to find a clinic much like 
a Planned Parenthood.
    Back in those days, we looked through the Yellow Pages and 
I found a clinic and I will tell you I was afraid to tell 
anybody that I was even going to go seek advice on what options 
there were.
    But I remember walking in and I remember being welcomed and 
being told, my first question was how much is this going to 
cost me? I didn't have a lot of money and I was told it was a 
sliding scale and I didn't have to pay.
    But it was just so important as a young person to have that 
opportunity to go and get access to healthcare. People think 
oh, well, there's healthcare everywhere. You can go wherever 
you want.
    But there are many people in low-income communities and 
communities of color that don't have the access to healthcare, 
and access is something that we have been fighting for and it 
is not as easy as going to wherever you want, especially not 
when you are 14 or 15 and you just want to go get advice and 
get some guidance.
    Dr. Robinson, we talked a lot today about how TRAP laws are 
medically unnecessary requirements imposed on abortion 
providers and women's healthcare centers.
    Can you maybe elaborate a little bit on the hardships that 
low-income women must face in states that have the TRAP laws?
    Dr. Robinson. Forcing women to continue a pregnancy that is 
just kind of a basic violation of a woman's basic humanity, her 
rights, and her freedoms.
    We know that when women can't access the healthcare that 
they need, be it an abortion or contraception, that it can 
further push them into poverty and there are studies that 
support that.
    It is not just our opinion as to the absolute fact. It is 
just really important for patients to be able to access the 
care that they need in a timely fashion and that women should 
be able to access the care they need in their community.
    Ms. Eshoo. Thank you. The gentlewoman----
    Dr. Robinson. And these TRAP laws are making it difficult 
for them to do that.
    Ms. Eshoo. Thank you. The gentlewoman's time has expired.
    I now recognize the gentlewoman from Delaware, Ms. Blunt 
Rochester, for her 5 minutes of questions.
    Ms. Blunt Rochester.  Thank you, Madam Chairwoman, and 
thank you to all of the witnesses, to my colleagues, all of you 
who have shared your stories.
    This is a very personal conversation as well as public, and 
I was sitting her thinking I am a daughter. I am one of three 
sisters and I am a mother of a 31-year-old and also a mother-
in-law. And it is surprising to me that in 2020 we are still 
having to fight for this right.
    I really appreciate the fact that we are having the 
conversation. I really appreciate it also hearing from the men 
who spoke up and shared their perspectives.
    I come from a state, the state of Delaware, that has been a 
leader in protecting women's health and safety. In 2017, 
Delaware passed a law recognizing the constitutional right to 
abortion.
    But instead of seeing more states across the country expand 
and affirm abortion care and access to comprehensive 
reproductive health services are being delayed and obstructed 
by harmful and medically unnecessary barriers.
    Every American deserves the freedom to make personal 
decisions about their health and their future. I really 
appreciated what you said, Ms. Alvarado, about the fact that 
these stories are, you know, really two sides of the same story 
and that the piece that I think links them together is that 
choice.
    We must pass the Women's Health Protection Act to safeguard 
abortion care and the ability for an individual to make 
personal decisions with fairness, safety, and respect.
    And I know there was conversation about speaking for those 
who can't speak. But there were many women who came before us 
who had to go in back rooms and alleys and have things done to 
them that were unsafe and unhealthy, and they had to either 
live or perish with the consequences, which is why what we are 
talking about today here is so important.
    I am glad we clarified some of the aspects of the bill and, 
Dr. Robinson, I really appreciated your bravery as well and 
your continued strength.
    Earlier this month, an individual in Delaware defaced our 
Planned Parenthood with an explosive. Thankfully, no one was 
hurt. But the incident shows that there can be personal safety 
risks for physicians and staff who provide or speak out to 
protect access to abortion care.
    So, again, I want to thank you for being here and really in 
the little bit of time I have I just want to ask you if you 
could talk about how Alabama's law has forced you to practice 
substandard care and what stigma has meant to your patients.
    Dr. Robinson. Well, the law has forced me to practice 
substandard care and do things that I would not normally do in 
the sense that, like I said, sometimes I have patients that 
present to our clinic that if I had my choice, they would be 
taken care of. Their abortions would be provided in a hospital 
setting.
    This may be women who have, for example, like very low 
hematocrits. They have a history of any type of bleeding 
disorder where they are on blood thinners. We need to take them 
off that medication for a period of time to be able to perform 
their procedure.
    If I could take care of them in the hospital, we could 
reverse their blood thinners in the hospital setting and take 
care of them and then get them started on their medication 
again.
    Patients who have a low hematocrit sometimes will be served 
better by being taken care of in a hospital. When I say low 
hematocrit I mean a low blood count. Because there is a blood 
bank available in the hospital where is--where they can access 
the resources they need if that becomes necessary. I don't have 
that available to me in my clinic setting. But these women 
still need abortion care.
    We have many women who have had multiple other abdominal 
procedures like multiple Cesarean sections. Our C-section rates 
are really high. And these women, when they present for 
abortion care, sometimes there is concern about the placenta 
being very adherent to the previous surgical scar.
    These women sometimes would be served better by being taken 
care of in a hospital setting. But I don't have that choice. So 
I have to give them the very best care that I can in my clinic 
setting, and this is the only area of medicine where it is like 
a zero sum game. You can't have any mistakes or any mishaps. 
But sometimes these patients may suffer complications in an 
abortion clinic and need for me to call an ambulance for them. 
That does not mean that we didn't provide good care. It just 
means that I was forced to care for them in a setting that I 
didn't----
    Ms. Blunt Rochester.  Thank you, Dr. Robinson. My time has 
expired.
     Ms. Eshoo. The gentlewoman's time has expired.
    I thank the gentlewoman.
    We will now hear from two members that are waiving onto our 
subcommittee today and I will call on and recognize the 
gentlewoman from New York, Ms. Clarke, for her 5 minutes of 
questions, followed by the gentleman from South Carolina, Mr. 
Duncan.
    Oh, we just had a Democrat. Mr. Duncan, you are recognized. 
The gentleman from South Carolina, Mr. Duncan, is recognized 
for 5 minutes for his questions.
    Welcome to the subcommittee.
    Mr. Duncan. Thank you, Madam Chair, and thanks for allowing 
members to be waived on.
    I want to thank the ladies on the panel today for your 
stories. A lot of them are very, very touching, and I have five 
stories from the Carolina Pregnancy Center in South Carolina I 
would like to submit for the record.
    [The information appears at the conclusion of the hearing.]
    Mr. Duncan. Thank you.
    I am an author of the ultrasound bill. I believe that 
requiring a woman to look at an ultrasound could save the lives 
of many, many babies.
    As a father of three sons, one of which was born very 
premature, I saw the ultrasounds of my boys. Saw the 
heartbeats, saw the little legs and arms kicking.
    And I am an evangelical Christian, a sinner saved by grace, 
and I want to read some scripture because as a Protestant, I 
have studied the Bible not nearly as much as I should.
    But I do know that in Psalm 139 verse 13 it says this, 
speaking of God: For you form my inmost being. You knit me 
together in my mother's womb. Job 10:11, you clothed me with 
skin and flesh and knit me together with bones and sinews. 
Psalm 119:73, your hands have made me and fashioned me. Give me 
understanding to learn your commandments. Ecclesiastes 11:5, as 
you do not know the path of the wind or how the bones are 
formed in a mother's womb so you cannot understand the work of 
God, the maker of all things.
    Isaiah 44:24, thus says the Lord, your redeemer who formed 
you from the whom I am the Lord who has made all things, who 
alone stretched out the heavens, who by myself spread out the 
earth. See in Genesis, God says let us make man in our own 
image and our likeness--after our likeness and let them have 
dominion over the fish, of the sea, over the birds of the 
heavens, over the livestock and over all the earth and over 
every creeping thing that creeps on the earth. Genesis 1:26.
    What that tells me is that as we are being stitched 
together in our mother's womb we are created in God's image and 
that God is in the womb as well.
    And when that baby--that little boy or little girl has his 
life taken in the womb, God is in there present for that 
murder. Scripture says we are made in the image of God. Are we 
are made in the image of God while we are stitched together in 
our mother's womb or after we take that first breath of life? 
When does that happen?
    To me, it happens at conception, because God knows me, know 
us as we are there. I guess I am here today to speak on behalf 
of the little boys and girls that are killed in the womb are 
those forceps are reached in and that back of the neck is 
pinched and brains are sucked out. Parts are pulled apart.
    Somebody has got to speak for them. Those are human lives. 
I am not going to sit here and say I understand what a woman 
goes through because I don't.
    But I understand what a father goes through. I understand 
what a father goes through that had a premature son who was in 
an incubator and I couldn't get my hands on him to hold him and 
how my arms ached wanting to pick up my son and hold him, not 
knowing whether he was going to live or die, because at that 
point when you are in the neonatal intensive care unit, you 
don't know.
    But I am not going to profess to know what the women feel. 
But the little boys and girls in the wombs they are feeling 
pain. We can kid ourselves that they are not. But they are 
human lives and they feel pain.
    Ms. Forney, I wasn't present for your story earlier but my 
staff told me, and I want to thank you for that. One quick 
question in 19 seconds.
    If a woman is required to look at an ultrasound, do you 
think more lives would be saved?
    Ms. Forney. Absolutely. Data proves that out.
    Mr. Duncan. Ms. Collett? If a woman has to look at an 
ultrasound, do you think more lives would be saved?
    Ms. Collett. I think the data is not conclusive on that 
question. It depends on where the ultrasound is performed.
     Mr. Duncan. Thank you all for being here.
    Madam Chair, I thank you for being waived on.
    I yield back.
    Ms. Eshoo. I would like to revisit something. I didn't 
catch what you said that you would like to place in the record. 
Can you--we will review it. Thank you very much, and thank you 
for joining us at the subcommittee.
    We have the gentlewoman from New York, Ms. Clarke, is 
recognized for her 5 minutes of questions.
    Ms. Clarke. Let me thank you, Madam Chair, for giving me 
the opportunity to waive on today. As vice chair of this 
committee, this is a very, very important subject matter that 
we must confront in the 21st century.
    We have a constitutional law and at the end of the day, we 
are still engaged in a debate that pulls at every one of us. 
Let me say that I am in full support of the Women's Health 
Protection Act. Full support. Full stock.
    The first Planned Parenthood facility was opened in my 
district--Brownsville, Brooklyn. That is right. And I believe 
in choice. The choice is whether you want to bring a life into 
this world and your circumstances support that, or the choice 
to have abortion care because your circumstances demand that.
    And when we get to the point where we are imposing upon our 
fellow Americans, women in particular, our preferences, we are 
going down a pathway that we should have evolved out of 
centuries ago.
    So let me thank you again, witnesses, for being here today. 
I want to talk to you about the provision of abortion care and 
what state bans are really about.
    We know that abortion is a safe medical procedure and yet 
targeted regulations on abortion providers, often called TRAP 
laws, make providing abortion care more difficult but not any 
safer.
    According to a 2018 report by the National Academies of 
Sciences, Engineering, and Medicine, abortion is safer than 
childbirth, colonoscopies, certain dental procedures, plastic 
surgery, and tonsillectomies.
    Madam Chair, I ask unanimous consent to put this report 
into the record.
    [The information appears at the conclusion of the hearing.]
    Ms. Clarke. However, we have seen hundreds of state laws 
and restrictions that single out abortion care under the guise 
of safety that seemed more focused on making access to abortion 
care more difficult.
    An American College of Obstetricians and Gynecologists in a 
published committee opinion on the topic, found that government 
restriction on abortion results in the, quote, 
``marginalization of abortion services for routine clinical 
care,'' end quote, and are, quote, ``harmful to women's 
health,'' end quote.
    The same national academy study found that the greatest 
threat to the safety and quality of abortion are unnecessary 
government restrictions.
    So my question is to you, Dr. Robinson. Will you discuss 
the safety profile of abortion in relation to other routine 
medical procedures like colonoscopies, tonsillectomies, or 
plastic surgery?
    Dr. Robinson. Abortion care is very safe. The risk of women 
having a bad outcome or having a complication with an abortion 
is less than one percent. According to the CDC it's less than 
the chances of having an adverse reaction to a penicillin shot.
    So abortion is already very safe and these restrictions 
that are being placed do not make abortion any safer for women. 
It only blocks access to care.
    Ms. Clarke. Do you agree with the National Academies report 
that found that state restrictions are more harmful to the 
quality and safety of abortion care than anything else?
    Dr. Robinson. I do agree with that.
    Ms. Clarke. What are some of the ways that abortion 
restrictions threaten the quality and safety of the care that 
you are able to provide?
    Dr. Robinson. Well, these restrictions they push--they push 
a lot of women out of the medical system altogether where they 
are not able to reach a safe provider to counsel them and give 
them proper care.
    Some of them are having to access care by the best means 
that they know, which is sometimes just accessing the care 
through the internet.
    They would be served better sometimes by being able to have 
a provider locally in their area. It decreases the number of 
providers who are available to provide care for women so that 
means that some patients will never reach a facility when they 
do need it.
    Ms. Clarke. Very well. And we have heard a lot of 
conversation here today, some factual's, some based on 
opinions. It is valuable to hear the perspectives of everyone 
here.
    But at the end of the day, part of the freedom of being an 
American is self-determination, self-meaning every human being 
irrespective of gender, and I resent the fact that in the 21st 
century, this next generation is being imposed upon. They have 
a choice. Ladies, young ladies, you have a choice and you have 
a right to exercise that choice.
    With that, Madam Chair, I yield back.
    Ms. Eshoo. I thank the gentlewoman. She yields back.
    And let's see. We have one more member waiving on to the 
subcommittee and that is Ms. Schakowsky from Illinois, and I 
believe that will be the end of questions from members.
    The gentlewoman is recognized.
    Ms. Schakowsky. I also thank our chairman for allowing me 
to waive onto this subcommittee. It has been very, very 
meaningful.
    I know that when I stepped out of the room, Mr. Gianforte 
allowed Ms. Collett to make incorrect claims about the opinions 
of medical professionals on the importance of abortion access.
    And I just wanted to read a little bit about the American 
College of Obstetricians and Gynecologists, which is the 
nation's leading medical specialists for women's health and the 
authoritative body in the development of the standards of care 
for women and not part of the abortion industry.
    And I am just wondering if Ms. Northup or Dr. Robinson, can 
you clarify maybe once and for all, probably not once and for 
all, what medical professionals have said about the legislation 
that we are talking about today?
    Dr. Northup--Ms. Northup first.
    Ms. Northup. Well, what I can say is about what medical 
professionals have said about the type of laws that the Women's 
Health Protection Act would address, which is that both ACOG, 
as we have talked about, and the American Medical Association 
have taken positions against many of these laws because they 
are not based on medicine and they are not based on good care 
of patients.
    And I would also just point to the American Medical 
Association has a brief in the Supreme Court case, along with 
13 other processionals, in which they are very clear when they 
talk about the admitting privileges law that the Supreme Court 
will look at, it is not medically necessary.
    Abortion is a safe medical procedure and nationwide, they 
say patients are being harmed by medically unnecessary 
restrictions on abortion clinicians.
    The American Medical Association doesn't take a position on 
whether its members should or should not provide abortions. But 
they take a position on these types of regulations that are not 
based on science and medicine.
    Ms. Schakowsky. And Dr. Robinson, are you part of the 
abortion industry? Is there some such thing as the abortion 
industry that is pushing a skewed view of the healthcare that 
you provide?
    Dr. Robinson. No. I am part of the American Medical 
Association, the American College of Obstetricians and 
Gynecologists. I am a proud abortion provider and an 
obstetrician-gynecologist who cares very deeply for my 
patients.
    Ms. Schakowsky. And I am assuming that you also provide 
prenatal care to women who want children and help facilitate 
that as well, right?
    Dr. Robinson. Yes, I do.
    Ms. Schakowsky. I also wanted to point out that in addition 
to, we have the, supporting this bill, the American College of 
Obstetricians and Gynecologists, the American College of Nurse-
Midwives, and the Society for Maternal-Fetal Medicine.
    So, you know, again, I think this idea, and you had time to 
talk about this abortion industry, that what we are talking 
about and what we are trying to protect--look, I am a mother of 
three, a grandmother of six, and we embrace our children and we 
call this choice because you, Ms. Collett, and you, Ms. Forney, 
are free to organize around this issue, to promote the issue.
    But we are talking about women having the opportunity to 
choose, not to prescribe one thing or another or to invite 
politicians into the room.
    I think that is what is so offensive. Ms. Alvarado, can you 
just talk about that for a minute? Or less, 41 seconds.
    Ms. Alvarado. Absolutely.
    No, it is incredibly infuriating that so many women not 
only face these restrictions that--similar ones that I face but 
they face even greater restrictions in their home states.
    Abortion access is healthcare and women are capable with 
their partners and their doctors if they so choose to make the 
decision to access this healthcare.
    Ms. Schakowsky. I know it must be frustrating to some. This 
is a pro-choice House of Representatives and all of the polling 
suggests this is a pro-choice nation.
    And I yield back.
    Ms. Eshoo. The gentlewoman yields back.
    I see that our colleague from Pennsylvania has joined us. 
Welcome to the subcommittee, waiving on. Mr. Doyle of 
Pennsylvania is recognized for 5 minutes of questions and you 
may proceed.
    Mr. Doyle. Thank you very much, Madam Chair.
    First of all, I want to say thank you to all of our 
witnesses here today.
    I want to especially thank Ms. Alvarado for your service to 
our country, which includes your testimony here today. Your 
story is one that I really hope has resonated with my 
colleagues on both sides of the aisle and I hope has made 
everyone on this committee think about our own history, our 
hopes and plans for our families and, most importantly, how we 
treat our neighbors.
    I, for one, am a co-sponsor of the Women's Health 
Protection Act because I believe that we need to treat our 
neighbors, women across America, with basic respect that allows 
them to make the best health care decision that is best for 
themselves and their families without interference of the state 
or federal lawmakers.
    So with that said, I know that I am the last person to 
speak here today and you have all answered a lot of questions. 
I would just like to start by asking both Dr. Robinson and Ms. 
Northup, are there any false or misleading claims that you have 
heard here today that you would like a few minutes to clean up 
or correct the record on?
    Anything you would like to add? I want to give you some 
time if there is.
    Dr. Robinson. Yes. One, the implication that women, when 
they come in to have an abortion procedure, that these women 
that they may need additional time. I am the physician. I have 
the opportunity to establish a rapport with my patients.
    I have the insight to know these women who may need 
additional time and these patients, after we counsel them, even 
though we have a mandatory 48-hour waiting period, there have 
been times when I have talked to a patient and have told her 
that perhaps she needs to go and take a little bit more time 
and come back. I don't need the state to put that restriction 
in place for me. I am already doing that for my patient.
    So every woman that comes through the door for an abortion 
doesn't necessarily leave with an abortion. Sometimes they are 
really just coming because they need someone to talk to and we 
are doing that already in our center and we are doing it well.
    Mr. Doyle. Thank you.
    Ms. Northup, do you want to add anything?
    Ms. Northup. Yes, just to correct what has been said about 
the breadth of this statute. The statute is very targeted to 
aim at being able to provide abortion care and get abortion 
care free from medically unnecessary limitations.
    So this is only about those directed abortion providers 
that are not medically necessary, and we have heard a lot about 
it will overturn the Hyde Amendment. That is not the case. That 
you will be forced to provide abortions. That is not the case. 
That it will change the standard of viability from Roe. That is 
not the case.
    It is directed at--this reason that in the 21st century, we 
are still arguing about this is that these laws are unfair 
attempts to close clinics, deprive women of access, and they 
make it unfair across the nation so that your zip code is 
driving whether you can access services. That is the target of 
this law. It is right for this moment and I urge again for the 
committee to recommend its getting a floor vote.
    Mr. Doyle. Thank you.
    And finally, Ms. Alvarado, is there anything you would like 
to add?
    Ms. Alvarado. Thank you so much.
    I share my story here today because these restrictions 
don't just live in a vacuum. I am a testament to these 
restrictions and how they affected my life.
    And I am only grateful that I had been empowered to make 
the best decision for myself and I am grateful to that 22-year-
old who had the fortitude to not only face those obstacles but 
pass them to make the best decision for herself.
    Thank you so much.
    Mr. Doyle. Thank you for being here today and I want to 
thank the witnesses.
    Madam Chair, thank you so much for your indulgence, and I 
yield back.
    Ms. Eshoo. The gentleman yields back and I thank you for 
coming. You are always welcome at this subcommittee.
    I now would like to once again thank all of our witnesses. 
Dr. Robinson, you have done an extraordinary job. I am sorry I 
had to cut you off. But I am generally very generous with time 
and go over, much to frustration of members on both sides of 
the aisle, because every word really counts and witnesses come 
here really loaded with very important information but know 
that it's--I am trying to adhere to the rules of the committee.
    Ms. Forney, thank you for coming and testifying. Ms. 
Collett, thank you. Ms. Northup, 17 years plus lawyering, and 
to Ms. Alvarado, you have heard the expressions I think from--I 
believe from both sides of the aisle thanking you for your 
service to our country and for--I always say it takes courage 
to have courage. Thank you for yours.
    So I would like to now submit the following statements for 
the record. What Mr. Duncan requested be placed in the record 
will be. Mr. Bilirakis's request will also be placed in the 
record, and I am requesting unanimous consent to enter the 
following documents into the record. It's a very long list.
    A letter from Dr. Steve Weinberger, executive vice 
president and CEO emeritus of the American College of 
Physicians, Dr. Barbara Levy, clinical professor of obstetrics 
and gynecology at George Washington University, and Debra Ness, 
president of the National Partnership for Women and Families, a 
letter from the Reproductive Justice Community in support of 
the Women's Health Protection Act, a statement from the 
Guttmacher Institute in support of the Women's Health 
Protection Act, a 2018 report from the National Academies of 
Sciences, Engineering, and Medicine entitled ``Safety and 
Quality of Abortion Care in the United States.''
    A report from the National Bureau of Economic Research 
entitled, ``The Economic Consequences of Being Denied an 
Abortion.'' A 2018 article from the American Journal of Public 
Health entitled, ``Socioeconomic Outcomes of Women Who Receive 
and Women Who are Denied Wanted Abortions in the United 
States.''
    A 2017 article from the Journal of the American Medical 
Association entitled, ``Women's Mental Health and Well-Being 
Five Years After Receiving or Being Denied an Abortion.'' A 
2018 article from the Journal of Medical Internet Research 
entitled, ``Identifying National Availability of Abortion Care 
in Distance from Major U.S. Cities'' systemic online search.
    A report from the Center for Reproductive Rights entitled, 
``Roe and Intersectional Liberty Doctrine: The Supreme Court 
Amicus Brief of 11 Story Tellers'' filed in the Supreme Court 
case June Medical Services v. G.
    A 2017 report from the Center for Reproductive Rights 
entitled, ``Evaluating Priorities: Measuring Women's and 
Children's Health and Well-Being against Abortion Restrictions 
in the States.''
    A 2019 report from the Center for Reproductive Rights 
entitled, ``What if Roe Fell?'' A statement from the ACLU in 
support of the Women's Health Protection Act. A statement from 
various LGBTQ groups in support of the Women's Health 
Protection Act. A statement from the Hope Clinic for Women in 
support of the Women's Health Protection Act.
    Testimony from the National Council of Jewish Women in 
support of the Women's Health Protection Act. A statement from 
the National Family Planning and Reproductive Health 
Association in support of the Women's Health Protection Act.
    A statement from Platform in support of the Women's Health 
Protection Act. A statement from various reproductive justice 
groups in support of the Women's Health Protection Act.
    A letter from various independent abortion care providers 
in support of the Women's Health Protection Act. A letter from 
53 faith-based religious and civil rights organizations in 
support of the Women's Health Protection Act.
    A statement from Representatives Chu, Frankel, and Fudge in 
support of the Women's Health Protection Act. A statement from 
Kristen Clarke, president and executive director of the 
Lawyers' Committee for Civil Rights under the Law in support of 
the Women's Health Protection Act.
    A statement from Toni Van Pelt, president of the National 
Organization for Women in support of the Women's Health 
Protection Act.
    A letter from MomsRising in support of the Women's Health 
Protection Act. Testimony from Martin H. Wolf, director of 
Sustainability and Authenticity for Seventh Generation, Inc., 
in support of the Women's Health Protection Act.
    A letter from 14 state attorneys general and the attorney 
general from the District of Columbia in support of the Women's 
Health Protection Act.
    A letter from the Freedom from Religion Foundation in 
support of the Women's Health Protection Act. A letter from the 
Women of Reformed Judaism and the Religious Action Center of 
Reformed Judaism in support of the Women's Health Protection 
Act.
    A letter from the Planned Parenthood Federation of America 
and the Planned Parenthood Action Fund in support of the 
Women's Health Protection Act.
    Testimony from the National Network of Abortion Funds in 
support of the Women's Health Protection Act. A letter from S. 
Nadia Hussain, Maternal Justice Campaign director for 
MomsRising in support of the Women's Health Protection Act.
    A letter from Vanita Gupta, president and CEO of the 
Leadership Conference on Civil and Human Rights in support of 
the Women's Health Protection Act.
    A letter from Catholics for Choice in support of the 
Women's Health Protection Act. A letter from NARAL, Pro-Choice 
America in support of the Women's Health Protection Act.
    Testimony from Lela Abolfazli, director of Federal 
Reproductive Rights at the National Women's Law Center in 
support of the Women's Health Protection Act.
    A statement from the American College of Obstetricians and 
Gynecologists in support of the Women's Health Protection Act. 
A 2019 article from the Journal of Obstetrics and Gynecology 
entitled, ``Consensus Guidelines for Facilities Performing 
Outpatient Procedures: Evidence Over Ideology.''
    A letter from five law professors in support of the Women's 
Health Protection Act. A compilation of 114 abortion stories--I 
believe I mentioned this right off the top--submitted by 
Representative Bilirakis. An abortion story from Elizabeth 
Gillette. An abortion story from Pam Thompson. An abortion 
story from Terry Fordone. A press release from the Susan B. 
Anthony list dated February 12th, 2020. A letter from March for 
Life Action opposing the Women's Health Protection Act. A 
statement from Americans United for Life opposing the Women's 
Health Protection Act. The Supreme Court amicus brief of 
Priests for Life and Rachel's Vineyard followed in the Supreme 
Court case June Medical Services v. G. An article by Thomas M. 
Messner, J.D., entitled ``The Women's Health Protection Act of 
2019: Ten Things You Need to Know About H.R. 2917.''
    So without objection, so ordered.
    [The information appears at the conclusion of the hearing.]
    Ms. Eshoo. And go ahead. You are recognized.
    Mr. Burgess.  You have covered most of them but also a 
unanimous consent request to add a legal analysis by the 
Charlotte Lozier Institute and just to be certain on the Susan 
B. Anthony list press release entitled ``House Democrats Hold 
Hearing Promoting Abortion on Demand.''
    Ms. Eshoo. So ordered.
    [The information appears at the conclusion of the hearing.]
    Ms. Eshoo. So I would like to remind Members, there are all 
of what, three of us left here--that pursuant to committee 
rules we each have ten business days to submit additional 
questions for the record--I certainly plan to do so--to be 
answered by the witnesses or witness who has appeared and I ask 
that each one of the witnesses respond promptly to any 
questions that are submitted to you by--that you may receive 
from a member or more than one member.
    So thank you again to each one of you. We have not taken a 
break. You have been at the table as long as I have for 
almost--let's see, almost four hours. And thank you to everyone 
that is in attendance here today.
    I think everyone has really comported themselves with a 
great deal of dignity, with professionalism, and as chair of 
the subcommittee I wanted to recognize all of you for doing 
that and thanking you.
    With that, the subcommittee is adjourned.
    [Whereupon, at 1:44 p.m., the committee was adjourned.]
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