Subcommittee Named to Review Abortion Statistics Bill

Five representatives from the New Hampshire House Health and Human Services committee have been named to a subcommittee studying HB 471, the abortion statistics bill that was retained in committee earlier this year.

New Hampshire is one of only three states that do not collect public health information regarding abortion.

HHS committee chairman Rep. Frank Kotowski named Rep. Bill Nelson (R-Brookfield) to chair the subcommittee. Other members are Reps. Lucy Weber (D-Walpole), Jerry Knirk (D-Freedom), John Fothergill (R-Colebrook), and Jess Edwards (R-Auburn). The subcommittee must report back to the full committee by November 1. The full House will take up the committee recommendation in January 2018.

Subcommittee work sessions have not yet been scheduled. The sessions will be open to the public.

Rep. Nelson chaired the study group whose work resulted in the last abortion statistics bill, HB 629, which passed the House in 2016 but was tabled in the Senate after an “ought to pass” motion failed on a 12-12 vote.

Update: abortion stats bill retained

New Hampshire House Bill 471, abortion statistics, has been retained in committee and will not get a vote in the full House until 2018.  This is a step sideways, but it keeps the bill alive.

A subcommittee is likely to work on the bill between now and January. I’ll watch for those work session dates.

This is 2015 all over again, when the last statistics bill (HB 629) was retained. A subcommittee assigned to work on the bill had six work sessions between May and October 2015. They produced what I thought was an improved bill that enjoyed bipartisan support. The full House passed the resulting version of HB 629 on a voice vote in January 2016.

Then the state Department of Health and Human Services got a new commissioner, who yanked the Department’s participation in crafting the bill. Planned Parenthood, whose representative had attended the work sessions (I know because I attended them as well), refused to support the amended bill. That was enough to prompt a pair of Republican senators to join ten Democrats in voting against HB 629. That tied the vote at 12-12 in the Senate in May 2016, and the bill then died after being tabled.

That was then; this is now. Under House rules for retained bills, HB 471 must come back for a House vote next year. Last time around, the House did its job: careful study with involvement from a variety of stakeholders, yielding a bipartisan bill so strong it passed without debate. I expect no less from them this time with HB 471. The Senate will then have a chance to redeem itself from 2016’s fiasco.

Oregon Public Health: a lot of unknowns in assisted suicide report

The Patients Rights Council newsletter provides a fine quarterly update on end-of-life legislation and its effects on people who are medically vulnerable. Their latest newsletter (viewable as a PDF) includes a summary of the most recent annual report from the Oregon Public Health Division about deaths prescribed and committed under the state’s so-called “death with dignity” act.

See page 3 of the PRC newsletter – and by the way, look at the data for “patients’ reasons for requesting assisted suicide” and see how far down the list you find “inadequate pain control” – and look at what the OPHD report doesn’t say. From the PRC update:

“…it’s the ‘unknown’ statistic that is most significant. In 98 cases – that’s 74% of all the reported 2015 prescribed-suicide deaths – the OPHD doesn’t know if anyone was present at the most critical time in the whole assisted suicide process, when the patient takes the lethal drugs. That means that the OPHD has no clue if the patient took the deadly dose voluntarily (as required by the assisted suicide law), or if it was disguised in food and unwittingly consumed by the patient, or if the patient was forced to take the drugs (the last two actions being clearly illegal).”

Public health, indeed.

New Hampshire Senate tables abortion statistics bill

The New Hampshire Senate on May 5 shot down an abortion statistics bill, tabling it after passage failed on a 12-12 vote. The failure of HB 629 capped a seventeen-month effort to craft a law that would permit collection of abortion statistics while protecting the privacy of all parties involved in an abortion.

Supporting HB 629 were twelve Republicans: Senators Forrester, Bradley, Cataldo, Sanborn, Daniels, Avard, Carson, Boutin, Reagan, Birdsell, Morse and Prescott.

Opposing HB 629 were ten Democrats and two Republicans: Senators Woodburn (d), Watters (d), Pierce (d), Hosmer (d), Little (r), Kelly (d), Lasky (d), Feltes (d), Soucy (d), D’Allesandro (d), Fuller Clark (d) and Stiles (r).

Why fight stats collection?

The full debate should be available on the Senate web site shortly. Look for the recording from May 5; the debate began early in the afternoon session.

Senator Kevin Avard presented the “ought to pass” committee recommendation for the bill. Opponents then launched into objections, which I paraphrase thus – and anyone who wants to listen to the original statements may do so via the link in the preceding paragraph:

• The bill calls for a $135,000 expenditure to set up the stats-gathering program, and there was no proper fiscal note to the bill.
• A woman has a constitutional right to abortion and therefore gathering statistics is an intrusive no-no. I’m not sure the senator making that claim would argue the same way about Second Amendment rights, but I frankly don’t follow 2A bills closely enough to know.
• Gathering stats would violate a woman’s privacy. That ignored the fact that the committee that crafted HB 629 was concerned about privacy from the outset, and the resulting legislation called for release of aggregate data with no personally-identifying information.
• No other medical procedure (“and abortion IS a medical procedure,” Senator Kelly admonished her colleagues), and certainly nothing that would apply to men, is subject to the statistics-gathering requirements of this bill, and therefore collecting abortion statistics is discriminatory.
• There is no “compelling need” to gather this information, since “abortion is a safe procedure.” The senator making that claim did not point out that there are no New Hampshire statistics to buttress the safety claim.

And so on.  A woman has a right to abort, and in New Hampshire she has no corresponding right to any data about the safety of the procedure she seeks. Public health  officials have no right to information on maternal morbidity following abortion, never mind if there are providers responsible for any untoward outcomes.

What the Centers for Disease Control says

When HB 629 was introduced in January 2015, New Hampshire was one of only three states not reporting abortion data to the federal Centers for Disease Control, which monitors abortion as a matter of public health.

From the CDC web site:

“CDC began abortion surveillance in 1969 to document the number and characteristics of women obtaining legal induced abortions. Many states and reporting areas (New York City and the District of Columbia) conduct abortion surveillance. CDC compiles the information these reporting areas collect to produce national estimates. CDC’s surveillance system compiles information on legal induced abortions only….[S]tates and areas voluntarily report data to CDC…

“This report is used for many purposes in the field of public health. In the past, it has been used to:

-Identify characteristics of women who are at high risk of unintended pregnancy.

-Evaluate the effectiveness of programs for reducing teen pregnancies and unintended pregnancies among women of all ages.

-Calculate pregnancy rates, on the basis of the number of pregnancies ending in abortion, in conjunction with birth data and pregnancy loss estimates.

-Monitor changes in clinical practice patterns related to abortion, such as changes in the types of procedures used, and weeks of gestation at the time of abortion. This information is needed to calculate the mortality rate of specific abortion procedures.

“Surveillance systems, such as this one, continue to provide data necessary to examine trends in public health.” [emphasis added]

The painstaking development of the bill

HB 629 was introduced in January 2015 and was retained a month later for further study, with the results to be presented to the House in January 2016.

I was present for most of the study meetings on this bill; the full docket is included as an image below. Participants in the study included legislators from the House Health Human Services and Elderly Affairs Committee, along with representatives of the state Department of Health and Human Services and the Department of Vital Records.

Also welcomed at the table were a representative of Planned Parenthood of Northern New England, and myself. Early in the process, I was representing Cornerstone Action, a policy group. After I left Cornerstone, the committee members continued to welcome my participation in the discussions. All meetings were posted in advance and open to the public.

Planned Parenthood had never supported a stats bill in New Hampshire before, and it was the hope of the HB 629’s sponsors that a variety of voices in the discussion could yield a workable bill.

All of us – regardless of party or any other affiliation – agreed from day one that patient privacy was critical to any statistics-gathering effort. Rep. Kathleen Souza, chief sponsor of HB 629, looked at what states with abortion statistics laws have done, and members of the study committee had access to that information.

When HB 629 returned to the House in January of this year, it did so in a version amended to incorporate the findings and concerns that came up in the study process. The Health Human Services & Elderly Affairs committee voted 12-1 to recommend “ought to pass” on the amended bill. It passed the House on a voice vote on January 6. The committee report to the full House contained this statement: “All stakeholders agreed to the final version of the bill.”

And then two “stakeholders” deserted. Planned Parenthood reverted to type. The other entity to drop its support was the state Department of Health and Human Services, now headed by a commissioner recently appointed by Governor Hassan.

Nothing in the bill changed between House passage and Senate consideration. The only change was in the political winds. Against those, public health didn’t stand a chance.

Status Quo

With the tabling of HB 629, New Hampshire public health officials will continue to rely on self-reporting by a few abortion providers.

Since there is no restriction in New Hampshire on who may perform abortions, public health officials will continue to be ignorant about who’s providing them and therefore will have no way of knowing if a provider has a history of harming women.

Information on pregnancy rates – legitimate public-health data, in the CDC’s view – will remain in by-guess-and-by-golly territory, with no reliable induced-abortion information to factor into the rate.

At what point in pregnancy are abortions being performed in New Hampshire? Surgical or chemical (“medical”) abortions? Complication rates? All remain unknown to public health officials and to women seeking abortion in New Hampshire.

The reason for New Hampshire’s willed ignorance is a mystery. Statistics are collected in nearly every other state, with women’s privacy protected and abortion in no way restricted by statistics laws. Statistics laws simply do not affect abortion rights or availability. Stats are a matter of women’s health.

On a 12-12 vote on May 5, women’s health got thumbs-down in the New Hampshire Senate.

State senators need to hear from you on abortion stats

New Hampshire is moving closer to an abortion statistics bill, but the effort has apparently not yet attracted support from the 13 senators required to send the bill to Governor Hassan. Several sources have reported to me that thirteen votes for “ought to pass” on HB 629 are far from assured. The bill has not yet been scheduled for floor action.

Please contact state senators as soon as possible and urge support for HB 629. It’s time for New Hampshire to join almost all of its sister states in collecting and reporting abortion statistics to the federal Centers for Disease Control.

Find all Senators’ contact information HERE. The phone numbers at that link go to the Senate offices.  At this point, calls will be more effective than emails or letters. Make a special effort to contact your own senator via phone or in person. Find your district HERE. Each senator needs to know that voters care enough about women’s health to insist on passage of HB 629. 

Privacy concerns recently expressed by at least one House opponent of the bill are a red herring. The confidentiality of a woman’s identity is preserved under the terms of stats laws nationwide and in HB 629 itself.  About four dozen other states have already served as a lab for this.

At least one House member has raised questions about the cost of the bill, estimated by the Division of Vital Records to be up to (not “at least”) $130,000. This is NOT a budget-buster. If the current budget has no room for this public health measure, the line item can be included in the next budget, if House and Senate agree for the bill to go into effect concurrent with the next fiscal year.

I was one of the non-legislators who participated in the 2015 meetings of a House study subcommittee that looked at abortion-statistics legislation. The committee’s work resulted in HB 629, introduced in January of this year. The chairman of the subcommittee, Rep. Bill Nelson, reported to his colleagues on the House Health, Human Services and Elderly Affairs committee that all stakeholders in the study agreed with the findings that led to HB 629. Representative Nelson then worked with Rep. Thomas Sherman to amend the bill to accommodate concerns of members of the full committee.  The committee passed the amended bill 12-1, and the House passed it on a voice vote. That’s about as non-controversial as a bill gets.

Here’s the House committee report by Rep. Nelson, who after studying abortion statistics laws for a year certainly understood questions about privacy and funding: “As amended, this bill provides statistical information that brings New Hampshire in line with 48 other states. The committee took care to be sure the identity of the patient is confidential and follows the Centers for Disease Control and Prevention (CDC) protocols. All stakeholders agreed to the final version of the bill.”

This bill has been in the works for a long time. It has bipartisan sponsorship from eight state representatives and two senators. It’s the result of painstaking study by legislators, representatives from the Department of Health and Human Services, an expert from the Division of Vital Records, and members of the public.

All the senators need to hear from you: YES on HB 629. Take no vote for granted.

RELATED POST on an earlier stats bill: Putting Down a Marker for Women’s Health