Contraception protections championed by NC lawmaker advance, but face GOP resistance

Rep. Sara Jacobs wants you to know she used birth control pills as a teenager to help with debilitating cramps.

She has an IUD for her birth control.

And she has taken Plan B over-the-counter when she needed it.

“I’ve lived my entire life with a constitutional right to contraception, and it’s a right I’ve exercised for decades,” Jacobs, a 33-year-old Democrat from California, said in a news conference Wednesday and repeated Thursday on the House floor.

That’s why Jacobs supported a bill introduced by North Carolina’s Rep. Kathy Manning aimed at protecting Americans’ rights to contraception.

On Thursday, the U.S. House voted 228-195, mostly on party lines, to pass the Right to Contraception Act. Eight Republicans joined Democrats in supporting the bill. None were from North Carolina.

The bill now moves to the Senate, where Republicans have more sway, and can generally block legislation that can’t win at least 60 of 100 votes.

The Right to Contraception Act

Manning championed H.R. 8373 after Supreme Court Justice Clarence Thomas released an opinion last month that said the court needed to review landmark decisions including one from 1965 that ensures Americans’ access to contraception.

The opinion came as part of the Dobbs decision that overturned Roe v. Wade, which had ensured access to abortions. States can now restrict abortions. The procedure remains legal in North Carolina.

“Let’s not forget that prior to 1965, states actually had laws prohibiting people from birth control,” Manning said in the news conference Wednesday with House Speaker Nancy Pelosi. “This rallying call by Justice Thomas and the actions of extremist Republican legislators are about one thing: control. These extremists are working to take away the rights of women, to take away our right to decide when to have children, to take away our right to control our own lives and our own bodies, and we will not let that happen.”

Manning’s bill has four key elements: protecting access to contraception, ensuring health care workers can provide contraception and information to patients, giving the ability to sue if access is prevented and protecting a range of contraceptive models.

Jonas Swartz, an obstetrician and gynecologist at Duke Health who has sub-specialties in contraception and abortion, spoke with McClatchy on Thursday following the House’s vote.

He said he and most of his colleagues have never practiced at a time when providing contraception wasn’t an option.

“I think that establishing rights to contraception seems to be very important right now,” Swartz said. “Before the Dobbs ruling, I would have thought it was obvious that people had the freedom to make decisions about their own bodies, but it seems clear that the Supreme Court may disagree with that conclusion in some circumstances, and it’s concerning that Justice Thomas seems to be signaling, specifically about contraception, that he doesn’t feel that that is the case.”

Using contraception

Swartz said contraception is safe and effective and allows his patients to prevent pregnancy and be independent. They can focus on school, their professional lives and their children and live out happy and healthy relationships and marriages.

Manning’s bill also ensures contraception can be used for other medical purposes.

Swartz said doctors use it to treat acne, male-pattern hair growth in women, and heavy bleeding or pain associated with periods. It is also used to treat fibroids, endometriosis, uterine cancers or precancers, mood disorders and monthly seizures related to their cycles.

Jillian Riley, North Carolina director of public affairs for Planned Parenthood South Atlantic, said the Dobbs decision “has provoked widespread fear and confusion across the country as people struggle to hit this new reality and take proactive steps to control their bodies and their futures.”

“It’s important to know that nearly nine out of 10 women of reproductive age have used contraception and nine in 10 adults agree that everyone deserves access to the full range of birth control methods, no matter who they are, where they live and what their economic status is.”

Opposition from Republicans

Despite those arguments, Republicans stood strongly in opposition to the bill Thursday.

Some said that had Manning thought to invite Republicans in on the process of drafting the bill, she may have had more of their support. On the House floor they said that the bill had been hastily and poorly written.

They said it would allow women access to contraception they believed posed risks and that the bill was a backdoor way of protecting abortions.

They also argued that it intends to provide further federal funding to Planned Parenthood.

“H.R. 8373 is a Trojan horse for more abortions,” said Rep. Cathy McMorris Rodgers, a Republican from Washington state. “It should be called the Payout for Planned Parenthood Act. It would send more tax dollars to Planned Parenthood, freeing up more funds for them to provide abortions and end valuable lives.”

Riley responded by saying that Planned Parenthood’s top priority is the health and safety of its patients.

“We offer the full range of contraceptive options, and our providers ensure that our patients have information about the benefits and the risks of any specific birth control method as well as answer any questions that they may have in order to help them make an informed decision about what contraceptive method is best for them,” Riley said. ”So obviously, we also support the right to abortion access, but this bill particularly is about the use of contraception, and it’s separate from abortion.”

McClatchy reached out to every Republican member of North Carolina’s delegation before Thursday’s vote asking where they stood on the issue. None answered, and none spoke on the House floor Thursday.

The debate

Swartz said he followed the debates leading up to Thursday’s vote and found the opponents’ arguments weren’t based in science. He saw claims that IUDs and Plan B were abortifacients and said that neither work that way.

“That is not the function of how emergency contraceptive pills work,” Swartz said. “Emergency contraceptive pills block ovulation — they block the release of the egg. They don’t function if you’ve already ovulated.”

Swartz said the copper in an IUD works to kill sperm.

As for Planned Parenthood, Swartz said, it’s often where people go for reproductive health care who don’t have access to care anywhere else.

Swartz said for every $1 invested in planning, the results are somewhere between $1 and $6 in savings through unintended pregnancy prevention.

One in four women throughout the United States seek contraception through publicly funded clinics, Swartz said, and about half of the 37 million women seeking contraception need public funding to access it.

“The Affordable Care Act made an incredibly important advancement by recognizing that contraception is one component of preventative care, and thus requiring that insurers provide contraception free of costs to individuals,” Swartz said. “So that means you should be able to go to your provider and get contraception without having to pay. Your insurance should pay for it.”

He added that North Carolina has many uninsured people because the state has not expanded Medicaid under the Affordable Care Act. Because of that, Swartz said that many people have fallen into a coverage gap and do not have access to contraception.

He said another group, unauthorized immigrants, don’t have access to publicly funded insurance programs and often can’t access contraception.

“I think it’s ironic that the people are pro-life and therefore want to prevent abortion, but are against the means of people who don’t want to get pregnant, preventing pregnancy,” Swartz said.

Support from Democrats

Rep. Alma Adams, a Democrat representing Charlotte, spoke on the floor Thursday in support of the bill.

“From reproductive care to LGBTQ rights and now to contraceptives, Congress has a responsibility to stop state governments from rolling back our rights,” Adams said. “My granddaughters shouldn’t have fewer rights than my daughter had.”

At the news conference Wednesday, Manning said she is not willing to play defense on this issue.

“We are playing offense,” Manning said. “My bill will get ahead of the growing threats to contraceptive rights because American women, indeed, all Americans, deserve the right to make critical decision about their health.”

How they voted

Voting in favor of the bill: Democrats Alma Adams, G.K. Butterfield, Kathy Manning, David Price, Deborah Ross.

Voting against the bill: Republicans Dan Bishop, Ted Budd, Madison Cawthorn, Virginia Foxx, Richard Hudson, Patrick McHenry, Greg Murphy and David Rouzer.

For more North Carolina government and politics news, listen to the Under the Dome politics podcast from The News & Observer and the NC Insider. You can find it at https://campsite.bio/underthedome or wherever you get your podcasts.