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The high costs of reproductive freedom 

At the beginning of May, a leaked draft of a Supreme Court opinion informed the public of the court’s position on overturning Roe v. Wade, the landmark case that has been used to protect the reproductive rights of birthing people across the country since the 1970s. Protests began to erupt throughout the nation as the fear of losing reproductive protections became real and the urgency of the situation more apparent.  

The chances of Roe v. Wade getting overturned became real for me on October 26, 2020, when the U.S. Senate confirmed Amy Coney Barrett to become a Supreme Court Justice. Justice Barret is clear about her political beliefs, specifically her position on Roe v. Wade. For decades, many states have pushed the Supreme Court to overturn this historic human rights case. With the addition of Justice Barrett to the bench, I knew the likelihood of the Supreme Court overturning Roe v. Wade increased exponentially. 

While Barrett’s confirmation was upsetting for many people, I found it terrifying. I am from Louisiana, a state well known for its conservative politics. I distinctly remember voting on a 2020 amendment that would add language to our constitution stating that the “right to abortion and the funding of abortion shall not be found in the Louisiana Constitution.” Much to my dismay (but not surprise), the amendment passed with 62% of the vote and is now part of the Louisiana Constitution. Legislation such as Louisiana’s amendment are referred to as “trigger laws”– laws that automatically ban abortion in the first and second trimesters if Roe v. Wade is overturned. As of today, 13 states have passed trigger laws. 

In response to the public’s concern and the growing fear of losing federal abortion protections, states like California strengthened protections for reproductive rights in their constitutions. California, specifically, is also reinforcing its ability to be a “safe haven” for those who come from states with trigger laws. Recent legislation in California is focused on expanding access to abortion and protecting individuals from legal liability if they travel to the state to get an abortion. Theoretically, that’s progress. Unfortunately, California residents often struggle with restricted access to abortion services, which presents a challenge. 40% of California counties don’t have a clinic offering abortion services, rendering them unaffordable and inaccessible for many.  

Given soaring gas and plane ticket prices, travel within and to a state like California is a luxury not equally accessible to every person, and consequently, the promise of California as a safe haven is only available to those who can afford it.  

It’s no shocker that like most bad policies, the overturn of Roe v. Wade will have a disproportionate impact on people living in poverty. Research shows that nearly half of those who have sought an abortion live below the poverty line. If they are residents of states that have restrictive access to reproductive services—such as only having one clinic in the whole state—people dealing with financial struggles often must consider additional factors when assessing their ability to travel to a reproductive health provider. These factors often include finding childcare, their ability (or inability) to take time away from work, and securing transportation. 

As we consider the future of reproductive rights post Roe v. Wade, it is crucial that people with lower incomes are explicitly considered and protected. That’s why Western Center continues to actively advocate for the maternal and reproductive rights of marginalized birthing people. 

Last year, Western Center worked alongside coalition partners to get SB 65 signed into law. SB 65 aims to improve data collection on race and economic-based factors that lead to higher rates of maternal and infant mortality in Black and Indigenous communities. It also creates a fund to support midwives and guarantees the option of obtaining a doula as a Medi-Cal benefit. While SB 65 does not address abortion, its passage expands reproductive protections for many Californians and reinforces the ability of birthing people to have agency in their reproductive journey. It also brought important dialogue to the forefront of the birthing rights conversation about the medical vulnerability of people existing in the intersection of non-whiteness and poverty. 

Bodily autonomy is a fundamental right that should not only be accessible to those who are better off financially. Until the reproductive rights of all people are protected, regardless of their economic status, we have work to do. 

Dalyn Smith is an intern at Western Center. She is a junior at the University of Southern California and is part of USC’s Agents of Change Program. 

 

Governor signs California’s Momnibus Act, to reduce racial disparities

“Jen Flory, policy advocate with the Western Center on Law & Poverty, thanked Newsom for “recognizing the need for California to face its Black maternal health crisis head-on.” By passing the bill, she said, “our state is making a down payment on the investment needed to correct the disparities Black and Indigenous birthing people have faced for too long.”

Governor signs California’s Momnibus Act, to reduce racial disparities

PRESS RELEASE: Co-Sponsors Respond to Signing of The California Momnibus Act (SB 65) into Law

For Immediate Release

SB 65 Secures California’s Position as a Leader in the Movement to Improve Pregnancy and Birthing Outcomes

SacramentoToday, Governor Gavin Newsom signed into law SB 65 (Skinner), The California Momnibus Act, marking a significant victory for maternal and infant health in California. The California Momnibus is an innovative and comprehensive piece of legislation that reimagines perinatal care in order to close the existing racial gaps in maternal and infant mortality and morbidity within the state. 

The California Momnibus Act sponsors applaud Governor Newsom for taking this pivotal step towards ensuring that birthing people and their families are supported in their birthing experience. A report released earlier this month by the Maternal and Child Health Division of the California Department of Public Health revealed that the pregnancy-related mortality ratio for Black women was four to six times greater than that of other racial and ethnic groups, indicating a widening disparity. Although California has reduced maternal mortality rates over the past 30 years, mortality and morbidity for Black and Indigenous/Native American pregnant people, women, and infants remain markedly higher than the state’s average.

Said Sen. Skinner, who is the principal author of SB 65 and vice chair of the Legislative Women’s Caucus: 

“Despite our medical advances, more U.S. babies and mothers die during birth than in all other high-income countries, and these preventable deaths are disproportionately higher for black families. This is unacceptable. I was so honored to Author SB 65, and to work with the Momnibus Coalition. Its passage will help close racial disparities in maternal and infant deaths and save lives.”

Said Nourbese Flint, Executive Director of Black Women for Wellness Action Project:

“California has led the charge when it comes to tackling maternal deaths and severe injury due to pregnancy in the country. But we know there is a long way to go, particularly when it comes to tackling the egregious death rates of Black mommas. With this signature, California takes a huge step in reimagining maternal care for our most vulnerable pregnant folk while setting the bar for the rest of the country. We can’t thank the Governor, Sen. Skinner, and her staff enough, as well as the broader legislature for investing in pregnant folks and babies.”

Said Amy Chen, Senior Attorney at the National Health Law Program:

“The California Momnibus tackles head-on some of the most pressing maternal and infant health disparities in our state, particularly for Black, Indigenous, and other people of color NHeLP is grateful to have been part of the statewide coalition that came together to push for its passage. We now stand ready to roll up our sleeves and work in partnership with the state agencies and community stakeholders to ensure smooth implementation of all parts of the bill,”

Said Jen Flory, Policy Advocate, Western Center on Law & Poverty:

“We are thankful to the Governor for recognizing the need for California to face its Black maternal health crisis head-on. It’s not enough to identify the deep inequalities that created this crisis. By passing the California Momnibus bill, our state is making a down payment on the investment needed to correct the disparities Black and Indigenous birthing people have faced for too long. We are also thankful to all of the organizations, individuals, and legislative members that have led in this space to reimagine what joyous birth should look like.” 

Said Shannon Olivieri Hovis, Director, NARAL Pro-Choice California:

“It has never been more critical for California to improve birth outcomes and close the state’s persistently high racial disparities in maternal and infant mortality and morbidity, especially for Black and Indigenous pregnant people. On behalf of NARAL Pro-Choice California and our 295,000 members, we are thrilled to see Governor Newsom prioritize birth equity today by signing SB 65 into law. Despite attacks on reproductive freedom across the country, California is continuing to lead the nation in maternal health and work toward a future where every body can access the care they need—no matter their income level, race, gender identity, sexual orientation, or where they live or work.”

Said Holly Smith, CNM, MPH, FACNM, Health Policy Chair of the California Nurse-Midwives Association:

The pandemic affected families and birthing people in both predictable and unpredictable ways, and especially laid bare the health care inequities that exist for Black birthing people, indigenous people, and people of color. SB 65 directly addresses these issues in an innovative and multi-faceted way. On behalf of the members of the California Nurse-Midwives Association, we give credit to the selfless co-sponsors and coalition partners who put so much time and effort into this bill, to Senator Skinner and the co-authors who brought SB 65 to life and saw the value each section of the bill brings to improving maternal and infant outcomes, and to Governor Newsom and the First Partner for seeing the need and making this a reality (and a first in the nation!). We are eternally grateful.”

Said Stacey Brayboy, Sr. Vice President, Public Policy and Government Affairs for the March of Dimes: 

“The March of Dimes applauds the adoption of this critical legislation and the full breadth of maternal health reforms California has enacted this year. Sen. Skinner and her colleagues in the legislature have demonstrated vision and leadership by raising up the inequities endured by BIPOC mothers and infants and ensuring the state is taking bold steps to close the gap in outcomes. I want to further thank Governor Newsom for his support of these initiatives and his ongoing commitment to realizing the changes we need to ensure all mothers and babies have a healthy strong start.”

Said Felisa Vallejo, Solis Policy Institute Fellow with Women’s Foundation California:

“Today’s win is about reimagining birthing and pregnancy in California. This bill protects new Black and Indigenous life and honors the ability of all genders to give birth – an investment and recognition that’s necessary across the country. We thank the organizations, individuals, legislators, and Governor Newsom for giving life to birthing and pregnancy health for all Californians.” 

Earlier this summer, Gov. Newsom signaled California’s commitment to improving maternal health outcomes by incorporating critical components of the original parts of SB 65 into California’s final budget for 2021-2022. This means: doula services and extended postpartum coverage are included as Medi-Cal benefits; an increase in the CalWORKS supplement for pregnant people; and a guaranteed income pilot that prioritizes pregnant people will soon be a reality for a large swath of Californians. Although maternal health enjoyed significant wins through California’s budget this year, critical steps to achieve equity remain. The sponsors are thrilled that Gov. Newsom continues to see this commitment by signing groundbreaking legislation into law. 

Background on SB 65

Through meaningful and responsive interventions, SB 65 addresses the maternal mortality crisis in California and advances equity in birthing outcomes by:

  • Codifying and expanding California’s Pregnancy-Associated Mortality Review Committee to investigate maternal mortality and morbidity with a mandate to look specifically at racial and socioeconomic disparities; queer, trans, and gender non-conforming birthing outcomes, and make recommendations for best practices to reduce maternal and infant mortality and morbidity;
  • Updating data collection and protocols for counties that participate in the Fetal and Infant Mortality Review Process;
  • Clarifying that pregnant people are exempt from CalWORKS welfare-to-work requirements; and
  • Building the midwifery workforce by establishing a fund for midwife training programs that meet the priorities of admitting underrepresented groups and those from underserved communities, or prioritize training and placement of graduates in California’s maternity care deserts. 

SB 65 is sponsored by Black Women for Wellness Action Project, The California Nurse Midwives Association, March of Dimes, National Health Law Program, NARAL Pro-Choice California, Western Center on Law and Poverty, Women’s Foundation of California Dr. Beatriz María Solís Policy Institute, and supported by over 70 health, rights, and justice organizations across California and the country.

Contact: cmckinney[at]wclp.org

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California bill aims to reduce deaths for Black mothers

“If you really want to address the issue, it is going to take a serious investment and resources, whether that means providing every Black mother a doula or really investigating what’s happening when Black mothers die,” said Jen Flory, policy advocate for the Western Center on Law and Poverty, which supports the bill.”

Read More

 

 

OPINION: How to improve California’s deadly record of outcomes for Black births

Nourbese Flint, Executive Director at Black Women for Wellness Action Project, and Jen Flory, Policy Advocate at Western Center, penned an op-ed in CalMatters explaining the need for SB 65 to combat California’s rising mortality rate for Black people who give birth.

Read Here

 

 

 

JOINT STATEMENT: California budget invests in pregnancy and birthing health; Momnibus bill can go further to address adverse birth outcomes in CA

The final 2021-22 California budget includes significant investments in new parent and infant health, many of which were part of SB 65 (Skinner), California’s Momnibus bill. While the progress made in the budget is substantial, SB 65 is still needed, as it contains additional provisions to reduce negative birth outcomes in our state. All of these comprehensive services, in the budget and in SB 65, are needed to address the disproportionate health disparities facing Black and Indigenous new parents and babies in California. 

We are excited that significant pieces of SB 65 are in the final budget. The following changes will be ground breaking for many families in California: 

  • A guaranteed income pilot program that prioritizes pregnant Californians.
  • Medi-Cal coverage for doula services, regardless of immigration status.
  • Earlier access to CalWORKs for pregnant people.
  • An increase in the CalWORKs pregnancy supplement.
  • Extended Medi-Cal eligibility for postpartum people.

“I’m very proud this year’s state budget includes funding to expand CalWORKs and Medi-Cal pre and postpartum services, key components of SB 65, the California Momnibus Act,” said Sen. Skinner, chair of California’s Senate Budget Committee. “These essential investments will help reduce the unacceptably high rates of maternal and infant mortality among Black and Indigenous pregnant people and their babies. I’m also pleased California is launching the first-of-its-kind guaranteed basic income pilot program prioritizing support to pregnant people. While there’s more to do, passing the remaining parts of SB 65 will help with additional measures to reduce birthing disparities.”

The budget investments mark significant progress, but California must go further to address its disparate birthing outcomes.

As the bill moves forward in the legislative process, we continue to push for:

  • Freedom from Welfare to Work restrictions for pregnant people on CalWORKs.
  • Birth data on lesbian, bisexual, transgender, intersex, and gender-nonconforming pregnant people in California.
  • Additional housing assistance for pregnant households.
  • State oversight of the Pregnancy Associated Review Committee investigating maternal death.
  • Updates to the Fetal Infant Mortality Review process to better collect information and prevent future infant deaths.
  • A midwifery training fund.

We appreciate our coalition’s continued support and Senator Skinner’s steadfast leadership as the bill heads to the Assembly Appropriations Committee in August, then on to the Assembly floor.

 

Overview of Western Center Priorities in the Final 2021-2022 California Budget

*PDF available here

After almost two months of negotiation, the Governor signed AB 128, the final 2021-22 budget passed by the Legislature. The Governor has not yet signed SB 129, which amends AB 128, and many trailer bills are not yet finalized. We will update this document as developments unfold.

As it stands, the budget marks progress for many Western Center priorities, including the expansion of health programs for new parents and undocumented Californians 50+, increased grants for CalWORKs and SSI/SSP recipients, increased funding for legal aid services, and increased investments in tenant protection.

FINANCIAL SECURITY

The state budget increases CalWORKs grants by 5.3 percent on October 1, 2021. Maximum grants by family size now slightly exceed 50 percent of the federal poverty level (FPL). CalWORKs households will also receive a $640 payment in July 2021 from the TANF Pandemic Emergency Fund. This budget increases the eligibility income disregard from $90 to $450 beginning May 2022.

CalWORKs Grants:

ACCESS TO JUSTICE/ FINES & FEES

The budget increases SSP grants by $36 a month beginning January 2022, and commits to making a second $37 payment starting in January 2024. It also eliminates the removal of people receiving the Transitional Nutrition Benefits for failure to fill out recertification paperwork within 30 days of the deadline.

The budget increases funding for the Equal Access Fund (EAF) by $50 million, for a total funding amount of $70 million. It also provides $40 million in funding for eviction prevention with 75% of those funds for organizations that receive EAF.

The budget provisionally repeals civil assessments for those who fail to appear or pay tickets in traffic courts. It also expands the online traffic adjudication pilot program to all counties. Indigent persons using the online tool get a minimum 50% reduction in the total fine amount and cannot pay more than $25 a month towards the remaining fine.

HEALTH CARE

The Medi-Cal budget has significant investments in eligibility, including elimination of the Medi-Cal asset test to ensure elders and people with disabilities are not impoverished by health care, expansion of Medi-Cal to all income-eligible adults age 50 and older regardless of immigration status, and Medi-Cal eligibility extension from 60 days to 12 months for all post-pregnancy individuals. Unfortunately, the budget excludes Medi-Cal coverage for undocumented adults ages 26-49 and continuous Medi-Cal coverage for children up to age 5.

Medi-Cal service expansions include addition of doula services, community health workers as a class of providers, continuous glucose monitoring systems for beneficiaries with diabetes, a permanent end to the suspension of certain benefits, and funding for field testing of translated Medi-Cal materials to ensure that documents are understood by the intended audience.

Even with the progress made in the budget, SB 65 (Skinner), the California Momnibus bill, still contains additional provisions to reduce maternal health disparities. AB 470 (Carrillo) will be amended to include any clean-up language for Medi-Cal asset test elimination.

In addition, there is funding for community-based organizations and local public health entities to address health disparities (delayed to July 2022), funding to zero out $1 Covered California premiums, and funding for the creation of the Health Care Affordability Reserve Fund to allow for future investment in Covered California subsidies.

HOUSING

The biggest success is AB 832, which will provide 100% payments towards arrears for eligible tenants who were unable to pay rent during the pandemic. The U.S Treasury dedicated a total of $5.2 billion in federal rental relief to support tenants for a total of 18 months. There is an additional $300 million in the national mortgage settlement funds for homeowners and $1 billion to the CA Housing Finance Agency for mortgage assistance and principal reductions, as well as an additional $100 million to expand CalHFA First Time Homebuyer Assistance Program.

There aren’t many changes from the May Revise for housing production. This budget includes:

  • $1.75 billion in one-time general funds to support Housing and Community Development affordable housing projects — 6,300 projects are currently shovel ready.
  • $81 million in one-time funds to expand CalHFA’s Accessory Dwelling Units (ADU) program.
  • $300 million in one-time funds to sustain Housing and Community Development legacy project affordability requirements.
  • $50 million for the Golden State acquisition fund.
  • $45 million in one-time GF to finance low- and moderate-income units.
  • Up to $500 million for Low Income Housing Tax Credits.
  • $50 million for farmworker housing.
  • $500 million in foreclosure intervention and housing preservation.

The budget also includes significant investments in homelessness funding:

  • $2 billion over two years for local jurisdictions to address homelessness.
  • $150 billion in one-time funds for RoomKey program to acquire and rehabilitate more housing facilities.
  • $2.75 billion for Project Homekey using American Rescue Plan Act and GF.
  • 50 million in one-time general funds for encampment resolutions services
  • $92.5 million in general funds in both 2021-2022 and 2022-2023 to expand program to provide housing support for eligible families experiencing homelessness in the child welfare system.
  • $50 million invested in the Homesafe program to support access to health, safety, and housing support for elderly people experiencing homelessness or at risk of homelessness.
  • $150 in general funds annually through 2023-2024 for people with disabilities who are experiencing homelessness under the Housing and Disability Advocacy program.
  • $40 million for homeless youth emergency service projects including rapid rehousing, rental assistance, transitional housing up to 36 months, supportive housing, housing navigation, and housing stability.
  • $25 million to the Department of Veterans Affairs that provide supportive services to homeless or at risk of homelessness veterans, for emergency or long-term housing support, among other things.

Finally, the budget includes an investment of $536,000 to the Department of Fair Housing and Employment to investigate and enforcement civil rights violations.

 

 

Joint Statement: California’s Momnibus Bill Continues On After Attempt to Stop It

UPDATE as of Wednesday, 4/28/2021: The California Senate voted to remove SB 65 from the Senate Human Services Committee and send it back to the Senate Rules Committee. On April 28th, the Rules Committee decided to send it to Senate Appropriations; Appropriations has until May 21st to advance the bill to the Senate floor.

We thank Senate Leader Atkins for acting to keep the bill alive, and Senator Skinner for authoring the bill and staying the course to protect birthing people in California. We are deeply thankful to everyone supporting SB 65 – your calls, tweets, and emails make all the difference.

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SB 65, California’s Momnibus Bill to address maternal and infant mortality disparities, was held by the State Senate’s Human Services Chair. Before it was held by Senator Hurtado, SB 65 had no registered opposition, and had unanimous support in the Senate Health Committee, with several members asking to join as co-authors. Now the bill is at risk, as it only has until April 28th to be heard in committee before it can move through the legislative process.

As written, SB 65 would provide additional health care via extended Medi-Cal eligibility for postpartum people, doula care, investment in the midwife workforce, and cash assistance for people with very low incomes through pregnancy and in the first years of their babies’ lives, all throughout California. These comprehensive services are needed to reduce the disproportionate health disparities that Black and Indigenous birthing people and babies face in California. SB 65 also added important state oversight to the boards investigating maternal and infant death to gain better understanding and make recommendations on how to reduce such disparities.

News that the bill would be held came as supporters and witnesses waited to testify on its behalf before the committee. This happened at the same time that the guilty verdict for Derek Chauvin was read. People around the world took the verdict as a sign of hope, that this country’s system of laws and policy may in fact have the ability to uphold the sanctity of Black lives. But for those waiting in vain to testify for SB 65 in California, it did not feel like Black lives were being protected, as politics got in the way of protecting people who face obstacles to healthy birth outcomes in our state — disproportionately Black and Indigenous people.

For many of us working for a more just future for Black lives, it is important that the lives we say matter are meaningful to us more than in just death. Making sure that we are actively working to dismantle systemic barriers, including socio-economic and institutional racism, is an essential part of the work. There is no excuse for SB 65 to be held. The need is obvious, the support is resounding, and Black and Indigenous lives matter. The California Legislature needs to show that they are willing to take action to protect not just Black and Indigenous birthing people, but everyone who will benefit from the passage of this bill, which includes millions of people in California.

 

 

As CoveredCA Enrollment Opens, Groups Trumpet Progress in 2019

This has been a banner year for making health care more accessible and affordable in California, according to consumer and health advocacy groups.

The open enrollment period for CoveredCA, which started this week, was expanded significantly – so people can now sign up for subsidized coverage on the individual market through end of January.

The state also expanded Medi-Cal to all low-income people under age 26, regardless of immigration status.

… Linda Nguy, policy advocate at the Western Center on Law and Poverty, praises a new bill to require better data sharing and implicit bias training for health care providers, in order to reduce the mortality rates for black women in childbirth.

“We’ve seen in California that, while the state has drastically decreased maternal mortality, for black women, the maternal mortality rates remain three to four times higher than for other women,” she states.

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A Black Mother Told Not to Scream in Labor Asks: Can California Fix Racism in Maternity Care?

Bettye Jean Ford was in her second trimester when the pressure she had been feeling in her abdomen for weeks turned to excruciating pain. She rushed to a Los Angeles emergency room, where she was diagnosed with a urinary tract infection and sent home with antibiotics. Still cramping severely, the first-time expectant mother spent the next 24 hours trying to sleep.

The next morning, her obstetrician found her dilated and sent her to the hospital next door where an ultrasound confirmed she was in labor. Rather than being admitted, she was sent back to the clinic with paperwork to finish.

…Advocacy groups including Black Women for Wellness and The Western Center on Law and Poverty, an anti-poverty organization, sponsored the bill after noticing how racial discrimination persists in medicine regardless of a patient’s ability to pay.

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