A couple of months ago, a Karl Rove disciple by the name of Florence Shapiro introduced Texas Senate Bill 785. Shapiro's bill required doctors to make detailed reports to the state about women who had abortions. The Senate passed it after removing sections making targets of judges who issued judicial bypasses, and even sending women to jail for failing to reveal highly personal information about their private lives to the state.
But now the bill is in the House, all the dangerous and intrusive provisions have returned with a vengeance, and the vote is tomorrow.
Should this legislation succeed, the confidentiality of personal information, and medical privacy as we know it, will become a thing of the past for women in Texas. And doctors, instead of inspiring confidence in their patients, will be forced by law to pressure women with emotional blackmail.
There is a growing trend for politicians to dodge the powder keg issue of abortion rights by mouthing innocuous-sounding platitudes about "reducing the number of abortions." But with a Christian right-approved Democratic initiative as political cover, Republican state legislators are leading a full-on charge, mounted for battle on a Trojan donkey.
The national push to collect detailed information from women who seek abortion care originated with the 95-10 Initiative of Democrats for Life (DFLA), a group with deep ties to the Christian right and various militant anti-choice organizations.
The current assault on women's medical privacy is being led by a Texas Republican senator who will never have to worry about access to health care for herself or for her daughters.
State Senator Florence Shapiro (right) learned how to run a statewide campaign at the knee of Karl Rove.
"The skill I think Karl brings is to take the long view," says Shapiro. "He knows every possible move, and he knows every possible response. He lays out a plan for you that is day-in, day-out." ... She learned her lessons well.
What Flo Shapiro wants, a dozen years of politicking in the Texas State Senate have taught her how to get.
For "family values" lawmakers such as Sen. Dan Patrick and Sen. Florence Shapiro, there's just not enough personal information to pry out of a woman before she's allowed to have access to abortion care. Like all other anti-choice politicians, they keep coming back for more — and this year, they intend to get it.
The "Abortion Reporting Requirement Act" — introduced by Shapiro as SB 785 — delves more deeply and intrusively into a woman's personal, medical and financial privacy than most well-meaning supporters of the 95-10 Initiative could imagine.
Although it denies a woman access to abortion care unless she opens the details of her personal life to the state, none of the data mined by its provisions has much to do with reasons why a woman might have an abortion. This legislation only serves — and could only be intended — to intimidate women forced to provide what should be confidential information to a state government deeply permeated [pdf link] by the influence of the Christian right.
Abortion statistics currently are submitted under a designated reporting number for each physician's office or facility, but do not include personal or identifiable information even about physicians — in fact, reporting rules forbid it. Now, however, Shapiro deems it necessary for the state to keep on file, in every instance, "the signature and license number of the physician who performed or induced the abortion." And personal information about doctors is only the beginning.
Shapiro has a record of supporting insurance coverage for women. This bill shows plenty of support for putting the insurance coverage of a woman who has an abortion on the record as well.
The abortion reporting form for each abortion must include:
:::
(14) whether the abortion was paid for by:
(A) private insurance;
(B) a public health plan; or
(C) personal payment by patient;
(15) whether insurance coverage was provided by:
(A) a fee-for-service insurance company;
(B) a managed care company; or
(C) another source;
(16) the fee collected for performing or inducing the abortion; ...
In addition to knowing how much a woman paid for her abortion, to whom the fee was paid, and by what method of payment, Flo also wants to know the name of the town a woman lives in, the age of "the father of the unborn child," how her pregnancy was confirmed, who referred her to the doctor who performed her abortion, how much her fetus weighed after the procedure and why the woman was having an abortion in the first place — which is the ostensible purpose for the bill. That information is the only detail a woman can keep secret without risking jail time, an omission that seems to render useless the ostensible purpose of such fact-finding missions as the "Abortion Reporting Requirement Act."
A woman needn't imagine that she can get on her high horse and refuse to answer any of the other questions. If she wants the state to let her have an abortion, she'll cooperate — on the record.
The patient must fill out sections of the form applicable to the patient's personal information. Sections to be filled out by the patient must be at the top of the form. The bottom portion of the reporting form must be completed by the physician performing or inducing the abortion. The requirement that the patient fill out the top portion of the form may be waived only if the abortion is performed or induced to prevent the death of the mother or to avoid harm to a mother described by Section 164.052(a)(18), Occupations Code, or harm to a mother who is a minor described by Section 164.052(a)(19), Occupations Code.
"A person" — either a woman or her doctor — commits a Class A misdemeanor, punishable by up to a year in jail, if s/he "fails to submit a form or report required" or "intentionally, knowingly, or recklessly submits false information on a form or report required." A physician can be fined and found in contempt merely for not getting the mandatory monthly reports turned in on time, let alone for refusing to compile or submit them.
And if a woman should see her own private physician, or any other doctor, for follow-up treatment after an abortion, the same reporting process starts all over again.
A physician practicing in the state who treats an illness or injury related to complications from an abortion shall complete and submit an abortion complication report to the department. The report may be submitted by mail or electronically filed on an Internet website created by the department. The report must include:
(1) the date and type of the original abortion;
(2) the name and type of facility where the abortion complication was diagnosed and treated;
(3) the name of the facility and of the physician who performed or induced the abortion, if known;
(4) the license number and signature of the physician who treated the abortion complication;
(5) the date on which the abortion complication was diagnosed and treated;
(6) a description of the abortion complication;
(7) the patient's year of birth, race, marital status, and municipality, county, and state or, if the person is not a resident of the United States, nation of residence;
(8) the week of gestation at which the abortion was performed or induced based on the best medical judgment of the attending physician at the time of treatment for the abortion complication;
(9) the number of previous live births by the patient;
(10) the number of previous performed or induced abortions for the patient;
(11) the number of previous spontaneous abortions by the patient;
(12) whether treatment for the abortion complication was paid for by:
(A) private insurance;
(B) a public health plan; or
(C) personal payment by the patient;
(13) whether insurance coverage was provided by:
(A) a fee-for-service insurance company;
(B) a managed care company; or
(C) another provider; and
(14) the type of follow-up care recommended and whether the physician who filed the report provided the follow-up care.
Reports on follow-up care must be filed not monthly, but within seven days, and may be filed via a Web site — yet another risk to medical privacy, The Austin Chronicle notes that "the state better ensure the security for that is crackerjack, because if a hacker got hold of that information and passed it on to one of the more fringe anti-abortion groups, the consequences could be horrific."
Current law already gives state inspectors an unimpeded right to access women's original and complete medical records at any time, and the Department of State Health Services may make and retain copies of those records for its own purposes. Considering the highly personal nature of the information to be included in the new reports, it seems reasonable to suspect that a woman's health might not be the primary focus of the state's interest.
Another bill by Sen. Dan Patrick pressures even women pregnant through sexual assault, or those whose fetuses are diagnosed with severe anomalies, to examine ultrasound images before being allowed abortion care.
Women in Texas already are denied abortion care until after a doctor warns them of nonexistent risks of breast cancer and mental illness, after which they must spend at least 24 hours pondering misinformation that no responsible physician would have given them, nor ever did, until forced by law to do so. Sen. Dan Patrick's SB 920 adds yet another moralistic barrier by denying a woman abortion care unless she examines an ultrasound image of her pregnancy. She can flat-out refuse, but the doctor has to push her until she does.
Patrick (left), is a Christian conservative talk show host and first-term senator who broadcasts his radio show from the Capitol. The notorious author of The Texas Baby Purchasing Act of 2007 had his own vasectomy performed live and on the air. Had a compulsory ultrasound viewing been a part of that procedure, we would all be grateful that Patrick is one publicity hound who didn't have a television gig.
In the wake of the Supreme Court ruling in Gonzales v. Carhart, many legal scholars "were startled by the implicit suggestion that women need to be protected from abortion."
But never mind. Religious right activists across the country have recognized this decision as a green light for further repression. South Dakota activist Leslee Unruh, architect of her state's 2006 abortion ban, says, "We're brainstorming, and we're having fun."
The Texas Legislature's anti-abortion forces — medical experts such as Florence Shapiro and Dan Patrick — think they know best, too. What they don't know is anything at all about the provision of abortion care. Perhaps they will allow someone who does know about it to enlighten them.
Obstetrical sonography is a diagnostic procedure performed for indicated medical reasons, not as a tool for emotional manipulation. A woman is free to decide that she would like to observe the screen during the ultrasound examination itself, or she may decide to accept our offer to review the image with her later, during a private counseling session. Despite anti-choice delusions, we encourage women to do so, because most women feel relieved that the ultrasound image actually looks like this ...
... instead of this.
If a woman decides that she would like to have a copy of the image to take home, we are more than glad to provide one for her at no cost.
But Patrick's very special late-entry bill takes all that arduous decision making off a woman's shoulders, so that she won't have to worry her pretty little head about it anymore.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 171.012(a), Health and Safety Code, is amended to read as follows:
(a) Except in the case of a medical emergency, consent to an abortion is voluntary and informed only if:
[:::]
(3) the physician who is to perform the abortion or the physician's agent performs an obstetric ultrasound on the woman on whom the abortion is to be performed, provides the woman with an obstetric ultrasound image of the unborn child, and reviews the image of the unborn child with the woman;
(4) the woman certifies in writing before the abortion is performed that:
(B) she has been provided with and has had the opportunity to review the image described by Subdivision (3); and
(5) before the abortion is performed, the physician who is to perform the abortion receives a copy of the written certification required by Subdivision (4) .
Most women are receptive to viewing ultrasound images, but it is understandable that others might prefer not to see them. Dan Patrick and his allies on the Christian right shouldn't be empowered to bully women to comply with their desires before being allowed to have an abortion, and they shouldn't be empowered to force doctors, and patient advocates like me, to do their strong-arming for them — even if Sam Brownback thinks it's a great idea.
Molly Ivins called our state the "national laboratory for bad government" because atrocious legislation implemented in Texas one year tends to be foisted upon other states the following year, or the year after. Should the national push to "reduce the number of abortions" become a federal mandate for government intrusion into the intimate details of a woman's life, anti-choice legislators in other states can be expected to show no more respect or restraint than Shapiro, Patrick or any of their cronies in the Texas legislature.
The House debate and vote are tomorrow. And relentless assaults on a woman's medical privacy need to stop right here, right now.
[This is an updated version of pieces that appeared at Texas Kaos and Talk to Action earlier in the legislative session.]
Title image: YourLaw Newsletter
Florence Shapiro: Houston Chronicle
Dan Patrick: Texas Observer
Protest photo: Lifesite