[Congressional Record Volume 165, Number 76 (Wednesday, May 8, 2019)]
[Senate]
[Pages S2724-S2725]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                           Women's Healthcare

  Mr. VAN HOLLEN. Mr. President, back in 1876, Ann Reeves Jarvis was 
teaching her Sunday school class about notable mothers in the Bible. 
She ended that class with this prayer:

       I hope and pray that someone, sometime, will found a 
     memorial mother's day commemorating her for the matchless 
     service she renders to humanity in every field of life. She 
     is entitled to it.

  That was the prayer of Ann Reeves Jarvis. Her 12-year-old daughter 
Anna, who was then a student in the class, took that prayer to heart 
and went on to help establish Mother's Day in the United States in 
1914.
  As we approach Mother's Day this upcoming Sunday, I am gathered with 
many of my Senate colleagues to urge our Republican friends here in the 
Senate to reject many of the policies coming down from the Trump 
administration that put women's health and well-being at risk. 
Americans need access to family planning services. An investment in 
family planning is money well spent because it helps families cope with 
reproductive health planning and can help prevent health crises. This 
is a win-win for those who receive these services and for all Americans 
who, in the long run, must pay for health services that are the 
inevitable result of neglect and failure to provide resources for 
family planning.
  While the Trump administration would have you believe that their 
efforts are solely focused on eliminating access to abortion, the 
reality is their actions are harmful to a broad array of family 
planning services. For example, just in 2017, the administration tried 
to eliminate the Teen Pregnancy Prevention Program grants more than a 
year early. I want to point out that the city of Baltimore had one of 
those grants, and with the help of programming from the Teen Pregnancy 
and Prevention Program, Baltimore saw a 61-percent drop in teen 
pregnancy between the years 2000 and 2016. The good news is that the 
city of Baltimore and other grantees prevailed in Federal court, so 
that money was restored.
  We now see repeated steps by the Trump administration through its 
recent title X Federal rulemaking that represent another attempt to 
restrict access to quality, affordable reproductive healthcare and 
prevent women from receiving the information they need to make informed 
decisions for themselves about their healthcare. It would jeopardize 
the entire title X health network.
  Specifically, the rule would block the availability of Federal funds 
to family planning providers, even if those family planning providers 
separately offer access to abortion services. In other words, despite 
the fact that Federal law is already crystal clear about no public 
funds being used to pay for abortion, the administration policy would 
ignore that reality.
  Under the status quo, title X-funded clinics that provide abortion 
must keep those services financially separate from their title X 
activities. So this rule would interfere with the ability of women 
throughout America to get that unbiased family planning service and 
counseling. The rule would specifically prohibit any referral for 
abortion services and end the longstanding guarantee that pregnant 
title X patients receive comprehensive, unbiased counseling.
  A primary goal of this regulation--and there has been no secret about 
this--is to prevent Federal funds from going to comprehensive family 
planning providers, like Planned Parenthood, with little or no regard 
for the impact this has on women throughout the country--and men and 
families. In fact, Planned Parenthood provides health services to 4 in 
10 women in America. For many women and men, Planned Parenthood is the 
only source of care in their community.
  I want to recount a couple of stories I have received from my 
Maryland constituents. One is from Caitlyn. She lives in Severna Park. 
She shared with me the impact that Planned Parenthood had in her life. 
She says that while growing up, she did not have a basic education when 
it came to reproductive health services and options. She writes:

       I knew I wasn't getting the whole story and I decided [to] 
     do my own research. Planned Parenthood had the answers to my 
     questions with no agenda, just facts.

  She went on to share a different firsthand experience she had with 
Planned Parenthood as a patient.

       I needed services that were quick, affordable, and 
     compassionate, and that's exactly what I received. When it 
     came time to pay my bill, I was surprised to find that they 
     just asked for a small donation. This donation-for-services 
     is possible through Title X. Because of Title X, patients 
     like me and more than 30,000 other Marylanders can access 
     care, no matter what, regardless of our ability to pay.

  That was Caitlyn.
  I also heard from Tamara from Takoma Park, MD. She moved back to 
Maryland to care for her aging mother and accepted her dream job. Her 
dream job was directing a training and education fund for healthcare 
workers. She hesitated to accept her dream job because the employer-
provided insurance plan was grandfathered into pre-Affordable Care Act 
regulations, meaning that her preferred form of birth control wasn't 
covered. Her prescription would cost her $125 a month, something she 
could not afford. Through her local Planned Parenthood, she was able to 
get the prescription for $20 a month. She wrote to me saying:

       Without my local Title X-funded community clinic, I--a 
     graduate of Wellesley College, a Master's Degree holder, an 
     engaged community member, a daughter, a passionate person on 
     a meaningful career path--would be unable to afford my 
     prescription, leaving me in the uncomfortable and, quite 
     frankly, unfair position of having to choose between my 
     health or quality of life.

  If you look at these stories, you will find that the proposed 
regulations coming down from the Trump administration prioritize 
ideology over patient health and safety and fiction over healthcare 
facts. So that is something about title X.
  I want to say a word about the Affordable Care Act, as well, and the 
important protections it provides for people throughout our country, 
but I want to focus for a minute on the protections it provides to 
women.
  It became the law of the land 9 years ago. I don't think any of us 
expected we would still be fighting as hard as we are to try to protect 
those essential healthcare protections. Despite the failure in this 
body and this Senate just last year to overturn the Affordable Care 
Act, we still see a constant effort from the administration, both 
through nonstop, harmful, regulatory efforts and a wholesale effort 
through the Federal courts. So I think it is important to remind all of 
us about what the consequences of stripping away all those protections 
would be. With respect to women's healthcare, it would do away with the 
provision that requires coverage of maternity care as an essential 
health benefit. It would reverse the provisions that ended gender 
discrimination, which previously allowed insurance companies to charge 
women higher premiums than men for their healthcare. It also would 
eliminate the requirement to provide coverage for preventive health 
services

[[Page S2725]]

like mammograms, screenings for cervical cancer, prenatal care, and 
regular well-baby and well-child visits with no cost-sharing.
  So it is important, as we look at the ongoing efforts to sabotage the 
Affordable Care Act in pieces or get rid of it wholesale, that the 
consequences of getting rid of that for women's health would be 
devastating.
  I heard from a constituent at that time; her name was Pamela. She had 
aged off her parents' insurance in college and became uninsured and, 
therefore, put off her medical care until she ended up in the emergency 
room, had to declare bankruptcy to get out from under her medical 
bills. She wrote me during that debate over the Affordable Care Act, as 
follows:

       Today my asthma medicine is covered with a nominal copay. I 
     can see my doctor before a case of bronchitis becomes 
     something worse, and I do not need to go to the ER for 
     treatment. Now I have a twenty year old in college who has 
     pre-existing conditions, unlike me she is still covered under 
     our health insurance and her prescriptions are affordable. 
     What happens to me, my daughter, and my husband who all have 
     pre-existing conditions if our insurance is allowed to go 
     back to the old days of charging more for our coverage? What 
     happens to my daughter if she can no longer be on our policy?

  Like many of us, I have other stories I have received from 
Marylanders who are either worried about losing their access to 
healthcare through title X or worried about losing coverage under the 
Affordable Care Act. I hope, as we reflect on all of the challenges we 
are facing and as we honor mothers on Mother's Day, we don't support 
actions that would actually degrade their access to important quality 
healthcare.
  I will close by urging my colleagues to reflect on the words of Ann 
Reeves Jarvis, who I mentioned earlier was the one who had uttered that 
prayer that led to the establishment of Mother's Day. What she also 
said was that we need to honor the ``matchless service'' that mothers 
and other women in this country ``render to humanity in every field of 
life.''
  I believe it is our obligation to make sure we provide access to 
quality healthcare and choices for all of our constituents and for 
every American. As we reflect on Mother's Day, be very aware of the 
impact our actions will have on women throughout the United States.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Missouri.