Lester Public Library
Andre Jacque
Proposed legislation in Wisconsin uses a novel means to erode abortion access: education.
Assembly Bill 206, authored by Republican Representative Andre Jacque, would ban employees of the University of Wisconsin schools and an affiliated hospital from performing or teaching abortion practices using outside facilities, including Planned Parenthood.
“I’m trying to get UW out of the abortion business,” Jacque told the Associated Press. “I’m on pretty firm ground here.”
Jacque is one of many state legislators trying to chip away at abortion rights. An April 2017 report from Guttmacher Institute found that in the first three months of 2017, legislators across the country introduced 431 provisions that would limit abortion access. A bill in Arkansas, which a judge has just blocked, would require a woman to receive permission from the biological father or family member before getting an abortion. Last week, the Texas Senate passed a bill that banned contracting between local and state government agencies and abortion providers and their affiliates.
The bill would ban employees of the UW System and University of Wisconsin Hospitals and Clinics Authority from making contracts or performing any services at private facilities that perform abortions. This targets the university’s relationship with a Planned Parenthood clinic in Madison, where UW doctors are paid to teach OB-GYN residents how to perform abortions.
By eliminating contact with private facilities outside of hospitals, the bill would essentially end abortion services and training through the University of Wisconsin System and UW Health’s OB-GYN residency training program. Currently, elective abortions are not performed at UW hospitals, as state law prohibits any state funds, including hospital funds, from being used to pay someone to perform an abortion.
The bill poses risks to the UW OB-GYN residency training program and the already-limited abortion resources for Wisconsin women.
UW officials argue that the bill would threaten the national accreditation of the school’s OB-GYN program. The national Accreditation Council for Graduate Medical Education (ACGME) requires that “programs must provide training or access to training in the provision of abortions,” though residents may opt-out for religious or moral reasons.
In a letter to members of the Wisconsin State Legislators, Alan S. Kaplan, UW Health CEO, and Robert N. Golden, dean of UW School of Medicine and Public Health, wrote that the proposal would threaten “to shut down our capacity to train OB-GYN physicians. If this proposed legislation becomes law, the reputation of all of our residency programs will suffer.”
Wisconsin already faces a shortage in OB-GYN providers, especially in rural areas. Nearly one-third of the state’s counties do not have an OB/GYNs physician. The bill would also threaten UW’s Rural OB-GYN Residency program, the first program of its kind in the nation to focus on rural women’s health.
“Anything that is going to reduce the supply of providers to a rural area is going to be very problematic,” Mike Murray, policy director for the Wisconsin Alliance for Women's Health, tells The Progressive. “Women that need maternity care or other women’s health care are going to have to be travelling significant distances and enduring real hardships that people in communities like Madison might not experience.”
Nicole Safar, executive director of Planned Parenthood Advocates of Wisconsin, agrees. “This bill would only exacerbate this shortage, meaning even less women in Wisconsin would have access to the critical health care they need, including prenatal and maternity care,” she said in a statement.
This reflects a wider shortage in maternal healthcare across the United States. The American Congress of Obstetricians and Gynecologists estimates that by 2020, there will be 6,00 to 8,800 fewer OB-GYNs than needed, with that number growing to 22,000 by 2050.
On July 18, the UW System released a fiscal impact statement warning that passage of the bill could result in the residency training program at UW Hospital losing its national accreditation. This would, it says, result in the loss of about $4 million in annual extramural grants and clinical trials receipts, and about $3.3 million to “recruit out of state [OB/GYN] physicians rather than in-state residency graduates.”
“In addition,” the statement says, “the loss of the residency training program and its impact on the [OB/GYN] department’s national reputation, and the resulting fiscal impact would spread to other areas and departments.”
Finally, “this bill would result in loss of such clinical sites and lead to costs associated with finding replacements sites for clinical rotations and training.”
The bill has been assigned to committee and could be taken up soon.