Speaking of Women's Rights: 08/13

Tuesday, August 13, 2013

Title IX and Sexual Violence: Tackling More Than Sports

by Megan Veith

“No person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any education program or activity receiving federal financial assistance.”20 U.S.C. § 1681(a).

When most people think of Title IX, they think of sports. As a female student athlete, I benefited greatly from Title IX, being able to play soccer, volleyball, track, tennis, and swimming just like my male classmates. However, Title IX benefits girls (and boys) in another critical way: it helps ensure that schools don’t ignore allegations of sexual violence, including rape, sexual assault, sexual battery, and sexual coercion.

How does the law do this?  A 2011 letter by the Department of Education’s Office for Civil Rights explains that the law imposes crucial obligations on schools to not stay silent about sexual violence. Importantly, Title IX effectively requires schools that know, or reasonably should know, of possible sexual violence to immediately investigate the situation. If the sexual violence occurred, the school must take prompt and effective steps to stop the violence, prevent it from happening again, and address the effects of the violence. Finally, the school must provide an avenue for students to bring Title IX complaints, including ones of sexual violence.

These obligations on schools are particularly important because one in four women will survive a rape or attempted rape by the time she graduates college. Men are also victims of sexual violence at school. Moreover, a recent study by the National Institute of Justice found that schools are grossly underprepared in sexual assault awareness training and education and only about 50% of schools have “specific sexual assault policy goals.”

Facts like these are taking a front page in the news recently as a number of students from at least 5 universities have filed Title IX complaints against their schools for failing to effectively respond to rape and sexual assault allegations, including the University of Southern California (USC), the University of Colorado at Boulder, University of North Carolina at Chapel Hill (UNC), Occidental College in Los Angeles, and Swarthmore College in Pennsylvania.  These complaints illustrate a range of problems.  For example, the complaint against USC alleges that a student was told not to discuss her sexual assault case with the police and that her experience wasn’t sexual assault because her attacker didn’t orgasm. The UNC complaint alleges that the school administration underreported the number of sexual assaults on campus and was hostile to victims that refused to remain silent about the violence committed against them.

In addition to the official complaints, students nationwide are organizing advocacy campaigns, raising awareness, and taking a stand. Unlike many groups before them, however, they have an important way to spread the word about what’s really going on at schools – social media. Activists are effectively and powerfully educating others through Facebook, Twitter, Tumblr, blog posts, and other online media outlets. A website, “Know Your Title IX,” has been set up just to empower students and inform people about their Title IX rights and help students report violence, change their school, support a survivor, and spread the word - an excellent step in working toward effective change.

Whether through filing a complaint, organizing an advocacy campaign, or raising awareness, ending the silence about campus sexual violence is critical to ending the violence.  While everyone has different experiences with sexual violence and no one can pretend to feel what a survivor does, it is important that everyone share their own experiences with sexual violence to make others aware of how prevalent it is and to help schools change their policies.

Speaking from my own experiences, throughout my educational experiences, I have received rape threats from multiple male classmates. I learned what it’s like to fear going to school the next day and to wonder if school administrators would take my complaints seriously while protecting my identity. I learned what it’s like to fear that people will find out what happened and blame me, complaining that I take things too personally or don't understand a "joke." I know what it's like to wonder that if I didn’t say anything, whether those classmates would carry out a similar threat on someone else. I know what it's like to live with regret that I chose to remain silent and did not effectively use my Title IX rights.

No one – ABSOLUTELY NO ONE – should fear going to school, to learn, to succeed. This is why Title IX is in place. Women and men are using Title IX to protect themselves and future generations from the inhumanity that is sexual violence. It is critical that all of us know our Title IX rights and spread the word to others so that all forms of sexual violence come to an end and that schools carry out on their undeniable obligation to protect their students.

Megan Veith is currently a legal intern at Legal Voice. She just finished her second year at Georgetown University Law Center, after graduating with her Bachelor’s Degree at the University of Washington. Megan is a strong advocate for women’s rights and is thrilled at the opportunity to fight for equality for all people at Legal Voice.

Photo credit here

Monday, August 5, 2013

From Access to Exclusivity: The Confusion Surrounding OTC Emergency Contraception for All Ages

by Megan Veith 

If anyone has been to a drug store recently, you may realize that there is a new box in the family planning section. Finally, women of all ages are now able to buy emergency contraception without ID or a prescription! After many legal battles over women’s right to choose when to have a baby and girls’ rights to make private health decisions, the FDA approved expanded access to Plan B One-Step last month. Jessica Arons, President and CEO of the Reproductive Health Technologies Project, celebrated this move, stating “[i]n a country where nearly half of all pregnancies are unplanned, effective and accessible back-up birth control isn’t just a matter of convenience; it’s an urgent health need.”

Plan B One-Step helps prevent pregnancy after sex by delaying or preventing ovulation. It does not work after you become pregnant and is not an abortion pill, but can actually reduce need for an abortion. To be most effective, it should be taken within 3 days after sex.

However, before people get too excited, the recent improvements still do not address a very serious concern – cost. Last week, the FDA granted the manufacturer of Plan B One-Step (Teva) exclusive rights to sell this drug over-the-counter to all ages. Essentially, this means that Teva has a sort of monopoly on selling this drug until 2016. This is troubling because Teva can now set the price for over-the-counter emergency contraception available to all ages.

Currently, Plan B One-Step costs between $40 and $50! That’s a lot of money for just one pill. Generic versions of this drug cost between $35 and $45. These high costs still result in barriers to accessing emergency contraception, for young girls and women who don’t always have this kind of money. Arons commented that women’s health advocates still have work to do since “[l]ower cost generics are still being held hostage to age restrictions and prescription requirements.”

Other emergency contraception options include ella, which is a one-pill drug that is available by prescription only. Ella differs from other brands because, unlike Plan B One-Step and other progestin-only drugs, it is made of ulipristal acetate and works closer to the time of ovulation. Also unlike other emergency contraceptive pills, ella is effective up to 5 days after sex, which is critical because sperm can live in a woman’s body for 5 days.  It is also believed to be more effective than Plan B One-Step and generic versions of Plan B One-Step, especially for overweight and obese women. Ella generally costs around $40.

There are also generic one-pill and two-pill levonorgestrel-based tablets. The generic one-pill versions will soon be over-the-counter for women 17 and older, while women 16 and younger will need a prescription. Generic two-pill versions are only available at the pharmacy counter for those 17 and older, while women 16 and younger need a prescription.

It is important that women’s health advocates continue to fight for their basic human rights. Being a woman shouldn’t mean that you have to pay more for necessary health care or that you should have to wait for government and judicial approval in order to take the best care of your body.

Megan Veith is currently a legal intern at Legal Voice. She just finished her second year at Georgetown University Law Center, after graduating with her Bachelor’s Degree at the University of Washington. Megan is a strong advocate for women’s rights and is thrilled at the opportunity to fight for equality for all people at Legal Voice.

Photo Credit Here

Thursday, August 1, 2013

Putting Mothers First: How the Affordable Care Act May Help Lower Maternal Health Costs

by Megan Veith

A mind-blowing article appeared in the NY Times recently about the high cost of having a baby in the US. As part of an interactive feature, the author asked the reader how much a pregnancy cost in the US. As an average woman in her twenties, who has never been pregnant before, I settled with an estimate of a few thousand dollars. The real answer shocked me: an average pregnancy in the US costs $37,341.

Surely, this was mistake! Was I reading the answer correctly? Did I mistake this for another country? No, no, no.

According to a recent study by Childbirth Connection, women with commercial insurance generally pay 12% in out-of-pocket costs (between $2,244 and $2,669) for childbirth, while women with Medicaid get nearly all costs of birth covered. Insurance providers and the government take up the rest of the bill, meaning taxpayers and health insurance consumers end up paying, too. Given that today health care is supposed to be more affordable, more patient-focused, and more evidence-based, I could not understand how a procedure that a majority of women face during their lifetime could literally break women’s hard-earned banks. I decided to investigate how this outrage could exist and whether the Affordable Care Act (ACA) would help lower maternal health costs for women.

The main reasons that pregnancies are so expensive in the US are the increased use of unnecessary medical interventions for low-risk pregnancies, such as C-sections and inductions, as well as the high cost of medical malpractice insurance for OB/GYNs. Moreover, cost-saving and effective alternatives to hospitalized births (such as the use of midwives or birth centers) are grossly underfunded and in some cases highly restricted or even illegal because state laws, with doctor support, make it difficult for them to become licensed even when they are just as safe (and arguably even safer) for women with low-risk births.  

Luckily, the ACA works to correct some of these problems. The ACA provides a number of benefits to pregnant women that will hopefully lower the costs of pregnancies in the US.

Some of the benefits are specifically applicable to pregnant women. For example, in terms of access to maternal services, the ACA mandates that plans allow direct access to an OB/GYN without prior authorization from a health plan or doctor referral. The ACA also provides better support for nurse-midwives and birth centers, which are more affordable than having a baby in a hospital with an OB/GYN.

In a ground-breaking move, the ACA also requires new insurance plans to cover women’s preventive services without cost-sharing (i.e. deductibles, co-pay, etc.). The services related to maternal health include breastfeeding support and supplies, gestational diabetes screening, and well-woman visits for prenatal care. Moreover, it also requires new insurance plans to provide an “essential benefits” package that includes maternal and newborn health services.

In terms of better assistance and education, the ACA includes grants for home-visiting programs which would provide information and services to at-risk communities about pregnancy. The ACA also provides better treatment for pregnant women needing comprehensive tobacco cessation services and for women suffering from post-partum depression.

The ACA also includes provisions that apply to all women, but will help pregnant women in particular. One of the most important changes the ACA makes is that it incentivizes states to expand Medicaid - so in states that choose to, Medicaid covers women at or below 133% of the poverty line. Importantly, it also prohibits certain insurance plans from denying coverage based on pre-existing conditions (such as C-sections), from rescinding coverage when a woman becomes pregnant or incurs high medical costs, and from imposing lifetime and annual limits. There are also provisions that cap out-of-pocket costs.

To make finding a plan easier, the ACA requires states to implement an online marketplace for people to make apples-to-apples comparisons on health insurance plans.

Finally, the ACA also fights gender discrimination by eliminating gender rating in certain insurance plans. Gender rating is where insurance companies charge women more than men just for being a woman.

Much more can be done to ensure that pregnant women are guaranteed their right to affordable health insurance – including, for example, ensuring insurance coverage for women who choose to terminate their pregnancies;  currently, the ACA places restrictions on insurance coverage for abortion.  However, at least the ACA is a step in the right direction!

Megan Veith is currently a legal intern at Legal Voice. She just finished her second year at Georgetown University Law Center, after graduating with her Bachelor’s Degree at the University of Washington. Megan is a strong advocate for women’s rights and is thrilled at the opportunity to fight for equality for all people at Legal Voice.

Photo Credit Here