senator whitehouse: good morning. i call this committee to order. we have multiple committees on which we serve in the senate and from time to time it's important to go check in at another committee to get in the queue properly and -- so senator grassley will be along. i'll make my ope i'll introduce the first three witnesses. senator grassley will introduce a witness, senator lee wnd then we'll proceed. we are here today to discuss women's rights, their right to bodilyght to set the course of their own life. and their right to economic freedom. i hear often that the budget committee should only be concerned with debt and deficits but any serious conversation about debt and deficits must also analyze threats to economic growth and stability. debt and deficits do not occur in a vacuum.

welcome. e result from the fiscal decisions that we make and from what we do that strengthens or that weakens our economy. reproductive rights, it turns out, are intrinsically tied to eeconomic opportunity. repronomic justice. restricting one, restricts the other. as professor myers, the leading economist in this space will testify today, we can measure the economic harms from dismantling roe v. wade, especiallyy marginalized communities. the dobbs decision triggered an immediate crisis for millions of women as antiquated at snapped back into place, and some states implemented new restrictions on reproductive freedom. our phillips and dr. spun, will explain how the draconian state laws put

patients, their families and physicians into heartbreaking situations. about 25 million women of reproductive age live in states with severe restrictions on abortion. most in states that failed to expand medicaid and already had higher rates of maternal death. black women are disproportionately affected as many li in southern states with the worst reinstructive policies, with existing structural barris care, and with already-high rates of pregnancy related complication and death. dr.s, too -- doctors, too, lose their freedom to practice medicine as they are trained, delivering patient-centered, evidence-based care. i hear ob/gyns about their colleagues in other states being put in impossible positions. with the lives babies but in jeopardy. for a great many reasons, often deeply personal and harrowing,

one in four women seek an abortion before age 45. one in four. that freedom to decide if and when to have a child affects a woman's life trajectory and her family's financial security. at the pivotal -- as the pivotal turn away study found, women who were forced to carry a pregnancy to term were four times more likely to li in poverty. the reverse holds true too. reproductive freedom and choice including abortions and loweredl mortality, increases women's earnings, increases the probably that women attend college, and . -- local economies. freedom turns out to have economic value. in planned parenthood v. casey, these economic values were part of he court's holding. the court said, the ability of women to participate eal and sof

the nation have been facilitated by their ability to control their reproductive lives. economists and researchers have since quantified the damage of state abortion restrictions to local and state economies. andñ&orrelation is easy. the more extreme a state's restrictions, the more its economy suffers. a new study estimates tha abortion restrictions cost the national economy on average $173 billion per year. inover turning roe and casey, a small right-wing majority of a captured supreme court inserted the government into the personal life decisions of millions of women. removing that freedom, never minding those this is a court members on

a mission. next may be the ability to take mifeprir tone a 15eu6 and effective medication. next could come the right to take contraception. even in vote roe fertilization is under the gun. if re-elected, trump could abuse executive power to remove mifepristone from markets or try to prevent abortion medications or contraceptives from going through the federal mail. the republican effort to ban mail order medication could cause even larger economic damage than dobbs. generations of women fought for the freedom to make their own personal decisions, they fought and they won. and their victory brought economic gains in which we all trying to to undo it all, leaving young women and girls in america with fewer rights than their grandmothers. women and girls have lives worth

respecting and protecting and no one should be forced to carry a pregnancy to term against their will. stripping women ofs a long shadr lives, and over their families' lives, and it costs a long shadow over our economy as well. congress should safeguard access to abortion and contraception and codify roe is something womd decide, it's just not the government's business. i will now turn it over to ranking member grassley. grassley: good morning, mr. chairman. i'm sorry i missed the last three hearings because i couldn't be here. senator whitehouse: it's great to have you back, to be healthy enough to be back and participate in hearings again. senator grassley: we are tackling a very serious topic this morning. abortion above all. is a moral and legal issue.

abortion is not an issue that lends itself to being looked at solely through an economic lens. after all, life is priceless. there's a reason this committee historically hasn't delved into this issue. it's not an issue easily distilled down to dollars and cents. typical of budget issues that this committee normally works on. in fact, it is rather dehumanizing. the chinese communists are the best example of this, when they instituted the one child policy. targeting female babies to external nation. and they did this thinking it would help their economy. but look what happened. chineses

backfiring and hurting the economy. i think right now we just saw statistics, there are no longer -- they're no longer the largest population country in the world, being supplanted by india. look at western nations like our own. we're also realizing we need more people to sustain the economy, and protect social security. i gues reason that we're the most immigrant welcoming nation by taking one million people legally every year into our country. so yes, having anddren has cost. but so does abortion on demand and the culture that lac

life. that said, here we are. i'm pro-life. pro-family. pro-woman. these views are not in conflict. were the alternatives to abortion -- where the to abortit in all but the rarest circumstances. numerous programs at the federal, state and local levels are available children, and families in need. to better assist families, congress should focus on reforms that increase coordination between all the federal programs we have. congress should simplify access to these programs. it should reduce duplications, promote work, or education.nates in our tax laws. for years, i've been championin.

i've worked to support, improve our adoption and foster care systems. long been a strong supporter of taxes and laws to promote adoption financial burdens associated with adopting a child. as then-chairman of the tax writing finance cmittee, now 20 years ago, i helped shepherd the bipartisan tax relief package that included much-neede updates on the adoption tax credit. additionally i'm a member of the congressional adoption and founder and co-chair of the senate caucus on foster youth and have worked for years to improve pols and support for those who open their hearts and homes to children in need. i'm also an advocate of the maternal infant and early

childhood home visiting program, which serves many mothers and children across iowa and other states. it's critical we support the most vulnerable in our society and this program has been a successful tool to improve though life of at-risk families. this con i've introduced the bipartisan healthy moms and babies act with senator maggie hasan. theis a culmination of my work as finance committee chairman where i solicit ideas from senators and stake holders including iowa health care providers on ways to improve maternal childcare. the public is issues following e supreme court dobbs decision. today this committee will hear from two witnesses who can tell us about the types of programs

supporting pregnant women and families. we a will also hear how folks on our local communities stand up by theirl neighbors to let them know that they aren't alone and coco -- and do have options. that's the type of message everyone can get behind. thank you, mr. chairman. i thank the witnesses, all of our witnesses, for appearing today. senator whitehouse: thank you, senator grassley, and again, welcome back. our first witness today,sor caif middleberry college. she's an applied microeconomist who uses statistical methodologies to measure the causal effects of reproductive policies on demographic, health, and economic outcomes.■ her work has been published in

leading journals in economics and public policy. she maintains and distributes data on abortion access to researchers and the public through the abortion access dashboard and open science framework. professor myers, thank you for being here. next we'll hear from dr. lela zahadi spung, a board certified ob/gyn and maternal fetal medicine fa six in colorado■ her bachelor's degree in biology and psychologist from the university of georgia and medical degree from emery university. she serves as a member of■x the smfm reproductive health committee and member of the education committee through the society for family planning. welcome. then we'll hear from mrs. allie fail lips. she's a lifelong and an activis.

she shared her heartbreaking abortion story online and international attention. turning her pain into passion she's dead kayed her time to speaking out and fighting back. mrs. phillips, we appreciate you very muc the time to join us. i will now turn to senator lee and ranking member grassley to introduce their witnesses. senator grassley: i have the privilege of introducing an iowan from story county, iowa. ms. tamara call. m.s.n. and r.n. she's a -- she's executive director of a medical clinic in ames, fully licensed community care clinic that provides professional medical services including consultations, well

women care, pregnancy testing, ultrasound, health education referrals. obira employees board sert did -- certified ob/gyn physicians, registered nurses, nurse paradecisioners, medical assistants and support staff. she holds a bachelor's degree in public health nursing from the university of kansas. i'm also pleased welcome ms. call's daughter to our hearing as well. thank you both for being here. senator lee: thank you, mr. chairman, ranking member grassley. it's an honor and privilege to introduce my friend leslie ford as one of our witnesses today. leslie is an adjunct fellow at the american enterprise innd social mobility.

and she's also the president of an entity called ford policy solutions. and member of the state of virginia's department of social services state board of social adopt and recommend policy solutions on various social programs within the commonwealth of virginia. she's personally served in the white house as a domestic policy adviser. and a special assistant to the president from 2018 to 2020 working on reforms to social safety net programs and also the administration's anti-poverty agenda. but mosttantly, it is a great opportunity for me to endorse -- to introduce her, and endorse her, because she's a former member of my staff. she's served as policy adviser in my office where she oversaw the pic education, labor and pensions and work on the development of a

whole lot of health and social safety policyfc bills and amendments, helped put together ground breaking legislation in a number of areas including education reform, welfare reform, just to name a few. she's of course moved on and become a thought leader and someone who has contributed to meaningful and prudent welfare reforms and anti-poverty measures. i look forward to hearing from all our witnesses, but especially ms. fords. senator whitehouse: tnk you very much. professor myers, please proceed. >> thank you for the opportunity i'm the john g. mccullough professor of economics. i study the and abortion on

economics. i'm not here as an activist. i'm presenting facts on the ways in which reproductive policy is economic policy.9r women ma half the of the labor force. their introduction into the work of whether or whenhe economy by to become a mother is the single largest e men and women's earnings track mostly right up through parenthood. but then there is a gap. even after the kids grow up and leave home. it is exacerbated by the lack ot of child care. of course none of this implies that women, men and society don't benefit greatly from children. i'm a mother of four. and for a time in my life i was the widowed single mother of

preschool aged children. i have no doubt motherhood reduced my own emi productivity. i'm also sure it's entirely worth it for me and a decision i'd make again. but that's the point. the tradeoffs and decisions about whether and when to become a parent are inherently personal and closely tied to our economic lives. and even the best laid plans of mice and men and■i■t let's add n can go awry. abortion is a common reproductive health care need. before dobbs, nearly one million pregnancies ebbed in abortion year. that's about 20% of all estimated pregnancies. at that rate, a quarter of women will obtain an abortion in their lifetime and when they do, women are often in precarious and vulnerable situations. most are young mothers. nearly three quarters are locome. more than half report a disruptive life event like loss of a job or housing instability. the most frequent reason women cite for seeking an abortion relate to their finances,

aspirations and ability to care for other children. this brings me to a key point. access to contraception and abortion empowers women to plan their economic futures. expansions in reproductive autonomy have gone hand in with women's economic progress. the enter ducks of the birth control pill in 1960 followed by the legalization of abortion in the early 1970's accompanied a period of social and economic change marked by women gaining greater education, strengthening attachments to the labor pors, entering new occupations and increasing their earnings. we all know that correlation isn't necessarily causation but in this case it is. ample evidence from multiple research teams uses tools that isole and measure of reproductive autonomy. the legalization of abortion rewrote women's lives. it reduced teen motherhood by one third and reduced teen marriages by one fifth. it reduced the maternal mortality of black women by 30%

to 50%. it allowed women to compete their education and increase their earnings. and in doing so it improved the lives of children, reducing the numbers living in poverty and numbers experiencing abuse or neglect. as they grew into adulthood these children themselves had higher rates of college graijuation, lower rates of single parenthood. it's notas though the salience of abortion access has gone away. one study finds as a result of being denied a wanted abortion, women experience a 78% increase in past due debts and a 71% increase in negative credit reporting. states enacting abortion bans have affected a quarter of women. the arch affected woman faces a journey of more than 300 miles one way.

if any of my kids needed health care 300 miles away i'd have them there tomorrow but not everyone is in such a privileged position. i know many people coming up multiple days off work is just not possible. you don't need to rely on anecdotes. the data tell us that nearly a f people in ban states seeking abortions do not find a way to obtain one. this is especially true for young people and people those e trip, poims have been restricted. the first set bans have ruled this 20,000 births that would not have occurred absent state bans. these children were likely born poorest and most economically fragile families many of which contain other childrens as well. right now dobbs is a life story. if abortion access were further

restricted if congress were to enact a national ban, we'd begin to play the 1970's in reverse, watching a reduction in women's capacity to fully participate in the nation's economy. to c feels about the ethics of making contraception and abortion aborn accessible, there's no denying the policies affect the economic lives of women and their families. reproductive autonomy is linked to economic opportunity. senator whitehouse: thank you. doctor? >> good morning, chairman whielthouse, ranking member grassley and distinguished members of the committee. i am a board certified fellowship trained obstetrician gynecologist, maternal fetal medicine and complex family planning physician. i perforgeneti testing, perform deliveries and provide abortion care. i'm here today as a fellow with

reproductive also a fellow withe american college of obstetrics and gynologist. i'm a brown woman who passes as white. a first generation wildchild of imgrants. i grew up in the southeast and cared for that community in the majority of my career. became a doctor because of my commitment to care for people without judgment throughout the course of their lives. whether i'm caring for someone who is ready to build a family, already parenting, grieving a loss or caring for someone who does not want to be pregnant. all of my patients have something in common. they're making thoughtful decisions about their health and well being and deserve high quality health care regardless of who they are and where they live. i want to be clear today that abortion is life-save, necessary, compassionate health care and should be available throughout preagen in nancy. i have had the honor of caring for a number of families who

needed abortion for a number of reasons, all of them medically need that journey with them and they were thankful to be able to access abortion care in their community. i've heard from these families later that they've had pregnancies that led to healthyn their lives. unfortunately, the dobbs decision wreaked havoc on the lives of people seeking care and the physicians who are doing their bunities. this is also true for myself and maymy family. after finishing my fellowship at washington university in st. louis i moved back to the south. i found i was the only physician able to perform abortion care. i was caring for miscarriages and devastating circumstances for my entire community. following the court's decision, tennessee's abortion ban went

into effect. this ban did not have any exceptions. not even fo life-threatening more thans and imposed severe criminal penalties. it became very clear quickly that i could no longepr that myd and deserved without facing significant risks to myself and my family. in one of the hardest decisions i have ever hado make, my family and i decided to move quuns ben, to colorado. the reality is i'm not alone. many■en forced to shift care or services they provide, relocate or cease offering care altogether. as a physician in colorado, i am seeing firsthand the consequences of this moment and they are far-reaching. i'm able to provide careased on patients and i decide together is safest and healthiest for their lives without political interference but so many patients who travel to us don't have that option at abortion, patients are having to travel farther and farther distances from their homes and

communities. not only for their abortion care but for all types of while aepl grateful to care for these people who made it to us, you can't help but think of all the people we kn have been forced to remain pregnant and don't have the means and resources to pay for the travel, childcare, additional time off from work, or keep up withhe the pushed later into pregnancy. we know from precent data that already thousands of people have been forced to remain pregnant since the dobbs decision. this is dangerous given for the mortality in and especially for people of color. we know the consequences of people denied abortion, even before the supreme c many people to access this care. people who are denied abortion fall into poverty, increase their debt, and have worse■, financial security for years following their abortion denial. inability to access abortion

care have and this is especially true for black and indigenous people. we cannot forget how collective economic security benefits restrictions harm our communities as a whole. despite these threats, i am unwavering in my commitment to support people in my home and community in whatever way i can. it shouldn't be this way. people should be able to get care in their own communities in a manner best for themle they t. i urge you to listen to the stories being told today by people who provide and access abortion care. i help this helps you understand that abortion care is not an isolated political issue. and how access harm all of us and the people we love. thank you for having me. chair whitehouse: thank you very much, dr. mrs. phillips, please proceed. e house, ranking minority member grassley, members of the subject committee. thank you for inviting me here

today. i'mally phillips and live in clarksville, tennessee. my husband works for a forklift company and i run a stphaul daycare out of our home. together we are raising my daug. we are not a wealthy family. we work hard to pay our bills on time each month. i spent the first sever yrs of her life as a sing many mom working three jobs while also finishing up my bachelor's degree. brian and i were excited to learn i was the fall of 2022. even more thrilled to find out that we were having a little girl. miley rose. until the day of my routine anatomy scan. at 19 weeks, when my doctor told us that they have found multiple concerning fet■'al issues. several days later, as i waited to meet with the fetal specialist, i had no way of knowing the next minutes would change my life forever. the fetal specialist came in to go over the results, and that list was extensive.

miley's kidneys, bladder, andv4 stomach were not functioning. only two of the four chambers in her heart were not working. there was no amniotic fluid protecting her, she had a rare brain condition. her growth was a month behind. and she had no lung development. we were not compatible with life. completely broken i asked, what do we do now? th doctor suggested i had two options. i could terminate the pregnancy, but due to tennessee's ban on abortion i would have to travel out of state for that health care. my second option would be to continue my pregnancy, but risk a miscarriage, still birth, or giving birth for her to be put right into hospice care. and then the doctor warned that the longer i stayed pregnant, the worse miley's condition would get, and the more at-risk my health would become. knowing i had a daughter and a family to live for, we made the

difficult desion to seek an abortion. so instead of tkpwraoefbg this devastating news -- grieving this devastating news, my mother and i began researchingnics for states that allowed abortions after 20 weeks. many did not have open appointments for weeks, and the longer i waited, the more and expensive the procedure became. ultimately i found a clinic in new york city that could get me in the following week. then i had to book flights, find a hotel, arrange ground transportation, and childcare for my daughter. we had to quickly figure out how to afford all of it. we didn't have thousands of dollars sitting in our bank account. i had to start a go fund me effort online the unexpected medical and travel costs. without the help of strangers on the internet, i would not have had the freedom to leave tennessee or to make my own medical decisions. rights that my state denied me. days later, i arrived at a new

york city clinic alone. due to security concerns only patients are allowed in. i was there for several hours when a new was no longer beating. chair whitehouse: take your time. mrs. phillips: distraught i called brianand, to tell him over the phone that our much wanted daughter was already gone. and that the abortion scheduled th day would be done immediately. i went into surgery alone, and i sat in recovery alone. i grieved her loss alone. in a city i have never been in. far away from the comfort of my home, my family, and my friends.

no one should be treated this way. not in tennessee, and not in the other 13 states that now criminalize abortion. this standard of care that i needed in my situation. two days later i flew back home to tennessee. i had to go back to my life like nothing ever happened. i have never felt as small and inconsequential or unsupported as i did then. i was so depressed that i couldn't go to work for another week after we got back. and all together brian and i lost three weeks of pay, which is rough for a family that lives paycheck to paycheck. my parents had to help us pay our bills the following month so we want to have another child. but we are terrified because tennessee still bans abortion, and criminalizes doctors for providing essential health care for pregnant patients. thank you for letting me honor miley's memory by sharing our

story today. millions of people live under these laws just like tennessee's. and i know i was lucky to get the care i needed, one should have to rely on luck to get essential health care. we must have a federal right to access the health care we need, no matter where we live or how thank you. chair whitehouse: thank you very much, mrs. phillips. our next witness is mrs. ford. mrs. ford: chairman white dust house, ranking member grassley, and committee members. thank you for the opportunity to testify today. my name is lesley ford, i'm an adjunct fellow for the american enterprise institute. my research helps vulnerable families to find pathwaysf i'd like to make a point about mothers having an unwanted preg tphapbcy.

many women facing abortion face challenges. but that's not the answer. we have a duty to focus on real solutions. we should hesitate to make policy that says abortion results in better outcomes for women. it is difficult to effects of an abortion on women's long-term outcomes. at best the studies only point to correlations. we should not draw conclusions from them. instead, we should focus on the factors that lead women to consider abortion. nearly nine in 10 women who choose abortion are unmarried. over half of women who choose abortion are in their 20's. another 8% are in their teens. many women who seek abortion do so fear economic hardship. and a majority of post aborive women say they chose that option because t experienced pressure to abort from the important people in their lives. we must address the socioeconomic challenges that push them towards abortion.

this leads me to my second point. the safety net should be reformed to address many of the challenges that women considering abortion face. the safety net does challenges women considering abortion face. the safety net supports vulnerable low income mothers giving tm assistance, cash assistance, health insurance andnc in many cases housing assistance for child care. despite good intentions the safety net often impedes the path to self-sufficiency, most notably the safety net broadly discourages work evenhe though employment is the best way for moms to break the cycle of poverty in the key indicator of whether their children will end up in poverty as adults. major programs have benefit cutoffs are phased outs the disadvantage married couples, the safety net discourages work and marriage. the safety net should be reformed for what social scientists call the success sequence, completion of at

least a high school education, full-time employment and marriage before welcoming children but even when an unplanned pregnancy may these milestones there is immense benefit to completing the steps after giving birth to.ft when following up with mothers 15 years after nonmarital birth there's nearly a 70 percentage point difference in the likelihood of being in poverty between those who complete the milestones and those who do not. we can and must do more to encourage these mothers to find a pathway to self-sufficiency. my final point is the government can't do everhing. mothers need the support of their communities. this means child support services must do even more to ensure noncustodial fathers contribute to their children's needs, we should engage nonprofit community targets a which i want to highlight 2700 pregnancy resource centers nationwide that provide wraparound services from other

care, housing, and so much more. i want to conclude by reiterating pregnancies present real challenges from others, abortion is in the answer, we can and must support these women empowering them to overcome the challenges they face. reforming the safety net is a crucial step, every american, low-income mothers deserve real opportunities for themselves and their children and it's essential to support mothers with the power of community. all mothers deserve a consistent supportive community toelping welcoming their children into the world and giving those children a bright future possible. i look forward to answering your questions.we >> thank you very much, next we have tamra call. thank you chairman whitehouse and ranking member grassley and other members of this committee for giving me an today.

my name is tamra call and i'm executive director at a medical clinic. our mission is to provide reproductive health care and support women in a way that empowers them to make informed, life-affirming decisions. james is home to iowa state university and 30,000 university students. i want to note there are several medical clinics around our country. we have been accreditation association for ambulatory healthcare or aaa hd which credits outpatient cl college student health cente, certification from aaa ac reflects dedication to high-quality clientele healthcare. we operate in compliance with e all hip laws and we are staffed by a nurse practitioner, radiologists and highly trained registered nurses. we have the privilege of working with smart, strong and resilient

overwhelmingly, the needs women communicate is not t much different from what we all need to. and empower us on a journey to be successful. obria provides healthcare for no cost includin testing, early ultrasound imaging, monitoring for ectopic pregnancy or miscarriage and providing medical and emotional support as well as after abortion care. we see hundreds of women at obria every year. we seeen who are in college and afraid they will have to drop out if they choose to carry their pregnancy. some are professional women who can'tdy have children but have more, some are struggling to make ends meat and adding a child feels impossible.pp others do not have support from the father as a baby. and extremely grateful and humbled to have the opportunity today to share a story that is

of women we have seen at obria. her name has been changed to protect her identity. i would like to introduce you to asa who. from pakistan to the united states alongdr with her two yog children. she made the move because her husband was not supporting her or her children. her husband came to the us to visit the children and during this visit asa became pregnant. she knew her husband would not provide support and she felt overwhelmed at the thought of caring for three young children. asa felton abortion was her only option. asa scheduled an appointment at our clinic to get more information about the decision she needed to make. the nursing staff performed a pregnancy test that provided her with information about abortionadopti and parenting. as copies with me today, i'm happy to share them with you. the staff listened to her concerns and provided support.

asa had an ultrasound and when she saw her baby's heartbeat she knew she wanted to parent. she felt heard, understood and supported which empowered her to carry her pregnancy. she is now successfully parenting her three children and has maintained her job at iowa state university. obria provides numerous support services and referrals for women. obria is a qualified entity in the state of iowa to provide presumptive eligibility insurance. this means prenatal care is fu being processed which obria assists women in applying for supplemental nutrition assistance program, family assistance program in iran childcare. the state of iowa has a life map of childcare providers and ssie one also connects women with housing resources. we provide women with referrals to childbirth classes, parenting classes, early head

start and parents and teachers which obriaer offers a communi to foster connection and support among women with young children. we also have referral partners to assist women with foods to bodhi, applying for a job, basic finance classes, transportation needs and medical care. a woman should never feel that abortion is her only option. when a woman walks into her abortion is her only option, the staff at obria prioritize open communication allowing woman to actively participate in her reproductive health care decisions. the woman is met with a holistic approach that considers her physical, emotional, social and financial well-being. this approach not only supports the woman in making an informed choice but also reinforces her autonomy and empowerment in navigating a reproductive journey. the information and relational support a woman receives at obria instills in her the

confidence she needs to be successful. most of our clients whether they choose to carry their pregnancy or not obria for care. what starts as a positive pregnancy test ends in a can provide support for women for years. thank you. >> thank you.bit of the human experience that when extremists want to take away rights and freedoms they speak in platitudes and generalities, jargon, if you will so, allie phillips, thank you for immediate and practical consequences of that on your particular family. obviously it was horrible for you. i understand it was a period fs

well. >> yes. anthank you for letting me share my story. brian is not her biological father, he is her stepdad a he was beyond thrilled to have his first biological child. adderley,6 who is an artistic adhd child full of energy and spunk, so she wants to be a big sister. she was over the moon excited when she found out i was pregnant lodz listening to my belly every night and she would make little toys for her sister to have when she was here. trying to explain death to a 5-year-old is already hard, trying to explain death of an unborn fetus, unborn baby ism) even harder. i had to explain to her that m

miley was very sick, that she was causing mommy to be very sick, that we had to let miley go in order for mommy to stay. as hard as it was, she understood that e needs her mom. and that her mom and potentially if we decide todo y again down the road, it was very hard for our family. i am in the year mark of when it happened, march 7th is when i arrivednew york city. february 24th is the day i found out it wasn't compatible. it is very hard for me to be here today to talkbo i know how important it is because my experience isn't exclusive. it's not unique. millions of women face what i do every day. >> in your testimony you used the phrase standard of care

which is a medical phrase. i would like to turn to leilah he what standard of care means in the context of mrs. phillips's experience and if will the conflict that this extremism has created between the established medical standard of care for certain situations and laws that have been forced onto these families. >> thank you, chairman whitehouse, for that question. st is a phrase that used within medical societies in order to determine what is best to take care of a patient, how we mo f what the what science supports. in a situation like what ms. phillips went through, standard of care is a deeply personal

decision for what that family wants, but ultimately, when we have a pregnancy that is not going to result in a live birth, the risks of continuing many families. far outweigh because of the risks of pregnancy itself. it's not a benign condition. we know we are onef the few industrialized countries that have a worsening and increasing maternal mortality across the country. abortion care is very necessary healthcare in order to provide the standard of care, not to mentionr the same pitch of eac -- procedure used at dnc for abortion care is used for miscarriage management. during my time in tennessee, because of the way the law was written, ectopic pregnancies, which are pregnancies that are dangerous and life-threatening because they implant outside the uterus, technically an

abortion in the state of tennessee so you he providerer was lifesaving because of their fear of criminalization. when someone's water breaks early, the standard of care to end that pregnancy because of theto the pregnant person, and we have evidence across the country, continuing a pregnancy, 5fold. >>on care. could you tell us a little bit about the care for these women and include the types of medical complications and emotional hurdles abortion in these women can experience? >> yes, thank you, senator grassley.

when a woman comes to our clinic, one things that we prepare them for is what the abortion procedure will il to give them factual information on that and we let them know what the symptoms of it migow if they need to seek care after an abortion. we had women come to us that are continuing to have pregnancy symptoms after an provide them with an ultrasound. if there are, they are at risk for infectionn so we will trea them, to help them through that. we also provide women with emotional support, by far the complications we hear most often from our clients are difficulty sleeping, depression, and difficulty in their relationship. we once had a woman call us after an abortion, she was struggling with feeling suicidal. her family knew she had had an

abortion and they were supporting her, but shee didn't feel they fully understood, so a nurse was able to connect her with resources to help her as she works through the emotions was experiencing following that abortion. we also have women who come to us after an abortion or miscarriage and they sayheunpr the products of conception that would pass in their home while they are alone, when they see faces and eyes in their bathrooms at home, they are shocked and grieved at the loss of the child they were carrying. >> mrs. ford, you made a point about our safety net system being disjointed and difficult for women and new mothers to navigate. are these programs and agencies that are more complicated than others and what can agencies currently do to make these programs easier for women to navigate?

>> thank you. yes. i would say that women normally experience a safety net that steeply fragmented. if they are looking to food assistance they go to one ance have to go to another agency, usually fill out a different application. if they are looking for help turning aw of domestic violence, that's a different application, different caseworker. if they are looking for assistance getting back into the workfoe and looking for workforce innovation opportunity, it is again not just a different application but a different location. i would pointo the state of utah as the most fully integrated state. the department of workforce services his integrated 50 federal programs into a single agency. they are empowered in the state of utah to be able to connect the person to anyone of 50 programs that ey are eligible for. most states are not able to do

that. the state i serve on, the state of virginia the department of labor is disconnected from the department of social services and you must fill out two applications and be treated by two different ones to the services to treat the circumstances that normally one family would face soki should priority to push families that are in need. >> tamra call. to take any time you didn't have time in your five minutes to tell us anything else the commte about your work with helping women who are pregnant or want to be pregnant. >> thank you. we are talking about economics today and women do often tell us when they come to our clinic they are considering an abortion because of the financial concerns of adding a child to their family. one of these women was a

teenaged mom who came to our clinic with a 3 year maxon were living in her car. she did not want to bring another baby into that situation, so she felt that af staff and being listened to and heard and understood the was a information about adoption which she considered but decided not to choose, but was le our community, help her to to apply for medicaid, food assistance and when she had those resources, she felt empowered to carry her child and we have the pleasure of continuing to have a relationship with this woman and the father of the baby initially was in and out but he has chosen to be involved and to assist her and just last full

benefits and will enable him to provide for his family. a so we are able to bet safety net for these women and children and men. we never have a woman come to us and say i wish i would have aborted my child. every woman who comes to our clinic who is financially strapped or in difficult situations once to keep their children and that network of people around them who will support them and walk through that with them without any judgment or shame. >> thank you. all of your witnesses. i'm particularly grateful that chairman murray is here because she's at the point of trying to head off the house republican caused government shutdown, so an murray. >> thank you, mister chairman bridge i appreciate you having this hearing today. since republicans overturn roe versus wade reproductive rights have really been under attack

like never before in our country and i'm glad we are here today to talk about something that doesn't get enough attention. that's a strong connection between reproductive rights and economic security. when republican politicians take away a woman's control over her own body they are also taking away women's ability to plan their families, their finances, and their futures on their own terms. the connection is more painfully clear than ever where your ability to get an abortio whether you can afford to travel out of state. can you take the day off? can you afford transportation?! do you have a place to sit a? do you need childcare?e? miss phillips just described dollars that that happened to her. there is a deeply cruel irony faced by women who are unable to get abortions because of

cost. women who are forced to stay pregnant by republican politicians. if someone cannot afford to get the healthcare she needs what do they think will happen when she's forced to have that child? how will she make ends mee republicans antiabortion extremism doesn't just mean of forcing women to stay pregnant. ultimately it often means women forced out of the workforce and into financial hardship with no support to spe■pak of. here we are where republicans want women to stay pregnant but do they want to force women to stay pregnant but today, house republicanss want to not fully fund wic. republicans want to force womee to give birth but don't want moms to have paid leave so they can recover from childbirth and spend time with their newborn. it is pretty clear that republicans want to force women to stay pregnant won't lift a

finger to help new parents i want you to know the democrats are working hard to help make sure women are able to decide when and how ty and we support those programs that families need. that is a pretty big difference to me. mr. chairman. missus phillips.art with you. thank you again for sharing your story. i know how challenging that is and i want to make it clear that you are not alone. there are literally hundreds of women out thereic probably thousands, who are facing the same choices you do. you are sitting next to a wiess who just described a totally different scenario that doesn't even apply to you and f this land that will keep you from getting the healthcare you needed. that story is not alone. everyone needs to understand that. can you talk to this committee again about the financial barriers that are out there for

women who seek abortion such as you had to do? because that's what happened to you and what that meantnt to y and your family when you were forced to go out of state all alone? >> yes, and thank you so much for the question and the opportunity toontinue to speak on my story. i will start by addressing the committee by saying pregnancy isn't a 1-size-fits-all situation.y reason to need an abortion is different. my fellow witness over here explained did not apply to my situation. this was a plan for and wanted pregnancy and unfortunately for us it wasn't in the cards for us to bring world and as a low income a family, ase you spoke, i was single mom forhe first three years of my daughter's like, i took two weeks off of work when she was born, unpaid, had to go back because i didn't have any option but to work to take care

of my child. i startedd the in-home daycare at my home, to be home with miley because we couldn't afford the infant child care which is about another mortgage payment in the state of tennessee. without the platform that i had online and without sharing my story and thank god it went viral when itca did because without the help of complete strangers i would not have made it to your, >> it has worsened long-standing inequities. talk about how abortion bans and restrictions have created new financial burdens for women of color. >> thank you for that questionb

every studth abortion restriction finds the women of color experience en greater effects of those restrictions, than non-hispanic white women. the reasons are complex. black women have higher rates of unintended pregnancy driven by lower access to contraception, lower rates of insurance, more likely to live in contraceptive deserts. also, raised in party interact in compl to create greater financial barriers of traveling, taking time off work, accessing childcare for women of color but we see much greater effect on that population. >> senator kennedy, then senator stabenow. >> professor myers, you are here at the invitation of my democratic colleagues, is that right? >> that is correct. >> in his opening statement, my friend senator

quote, reproductive justice is economic justice. do you agree with that? >> i might as an economist use the word rights. >> that's not true for the baby, is it? >> first of all, i would refer to a fetus. i refer to it as a baby. that's not true for the baby, is it? >> the evidence i presented to you, senator kennedy, was evidence about measurable effect on the lives of women and families -- >> that is not true for the baby, is it? >> i don't understand. >> let me be clear. >> as an eno

>> reproductive justice. the babies did. >> i don't know how to answer your question. >> was the baby dead or alive? >> i'm referring to a fetus. >> is a fetus dead or alive? after an abortion? >> the fetus would be dead after an abortion. >> if the mother is healthy and is healthy, do you support abortion up to the moment of birth? hard question to answer because it doesn't happen. are asking me about something that simply doesn't happen. i will tell you -- >> it is legal in vermont, new jersey, oregon, colorado, new mexico, alaska and district of

columbia. the loon wing of the democratic party support abortion up to the moment of birth. do you support that or oppose it >> i don't think -- let me say i am here to talk about the economics of abortion. >> you are here as an expert.ke >> i will answer person -- i will tell youn i have ambivalence about abortion. i wills tell you as a person i haven't personally had an abortion. and understanding how complex the decisions are that people face, i am uncomfortable. >> i don't think you're going to answer my question. >> i trust women and their healthcare providers. >> you either support abortion or a healthy mother and baby up to the moment of birth or you

don't. and i don't think it is a difficult question. how about you, doctor? do you support if the mother is healthy and the bab h the moment of birth? >> you are using inflammatory it is not a simple yes or no not to mention when you make statements like that, you're erasing the grief and the trauma. >> are not going to answer my question. >> it is not a question -- >> i know your answer. leslie ford. let's take a baby at 21 weeks. this is a baby at 21 weeks, okay? the baby can feel pain, right? and the baby is pretty developed, all right.

do you know the name of the procedure the doctor would use to abort the baby at 21 weeks? >> i'm not a doctor -- >> it's called dilation and evacuation. is that right? >> as far as i understand.d. >> the doctor would dilate the and the doctor would call it a software plant, it is when a pair of pliers with sharp teeth on the end, without giving the baby any pain medication the doctor would go through the regina, through the uterus and start tearing the baby apart, is that right? >> as far as i understand. >> might start with the legs and pulled him out and the arms and pull t and then she might go for the heart or the spine and pulled the baby out piece by piece.-

is that right? without giving the baby pain medication. >> that's what i understand the procedure to be. >> you got to get the head out. the baby is dead but maybe not, maybe still in pain but then you got to get the head out and with the cervix dilated you got to get theat head out which is hard. than the doctor would go in and use those pliers to crush the baby's head, is that right?st >> as far as i -- >> then pull the head out, the crushed skull out, right? >> your time has expired. >> you gave the others plenty of time. >> just letting you know your time is expired and other senators are waiting. when you were ng letting others. i'm sorry youon don't want to hear -- >> i don't think anybody -- >> that was what we are here to >> no one else has gone over. the witnesses went a little long on both sides. >> i thought: we were here abt protecting mothers and killing babies. >> i'm going to turn to senator

stabenow. >> my apologies. >> i know it is ugly but -- >> i am so sorry you had to hear that, talking about the 1-year anniversary of what you had to go through. it was shameful and i'm very very sorry. no one here should be judging you or any other woman who has to make decisions based on their life and what's happening in their pregnancy. thank you so much for being here. this is about the freedom to make decisions, healthcare decisions for women. half the population, freedom to make our own health care ■ decisions. michigan, after roe versus wade was overturned, women across michigan put this on the ballot

for the constitution and 2022, overwhelmingly, democrats, republicans, people of voted to put in michigan's constitution the freedom to make ourlt own reproductive health care decisions, which i national abortion ban being talked about by republican colleagues and if we have a republican president, national abortion ban takes that all away and we also know that ibf now which is the choice to have a baby and go through ibf, that also potentially is being taken away and probably birth control is next so this is about basic freedom. i want to start differently than i had about no woman should feel abortion was their only option was i couldn't agree more. on nutrition issues, healthcare issues. i've been at the forefront of all of these issues and coul

not agree more but listening to missus phillips's story today do you think she had another option? >> thank you for the question. i'm o not a medical doctor but do know our ob/gyn has worked for over 30 years and has delivered over 4,000 babies and i know he has cared for multiple women who were in a similar situation to missus phillips and i know that he works closely with them -- >> in the interest of time.■k you are saying her baby was dead but she had another option. >> when her baby is dead it is no longer an abortion. at that point it is a dnc. >> i appreciate your work, but again, there's a lot of different stories to tell here. also. i wanted to ask missus ford,

the safety net, couldn't agree more on that. we have a situation where we need, we are working to fund the act for pregnant moms and babies, healthy food and nutrition. do you support wicked? >> it's an important resource for mothers especially providing formula to their children. >> we shouldn't have waiting lists which is going to happen if we don't fully fund wake. seems to me if there's a 9-month pregnancy you don' go on a waiting list so you mentioned work as being a support, that is something you would support? >> yes. >> i've been trying for years to put in place quality standards for labor and delivery under medicaid. half hour babies are born with medicaid, healthcare and republican colleagues have stopped of that in the senate r we don't have quality standards. i assume as part of the safety net you would support that, quality standards for labor and

delivery? >> yes, especially post-abortive care. fewer than 20 states actually track posterboard of outcomes, most abortion clinics actually when experiencing trouble are normally referred to a hospital er. >> talking about healthy babies. we should have that and colleagues should be working together to do that. and i assume you would support having quality standards as well. because of this body. missus phillips, let me go back to you.mr thank you again how has this horrible experience you had to go through changed the way you future in the kind of world you want your daughter to grow up in? >> thank you for the question.

it has been extremely difficult. as i stated before this was a planned and wanted pregnancy. we want to expand our family, something we plan to do but while the band still sits in tennessee, we are terrified. ittr was a very traumatic experience i had to go through, that my family had to go through. my card here says mom and st activist. since what happened to me happened. i have turned activism because my daughter is growing up in a state without bodily autonomy. my daughters growingy up in a state that lawmakers are telling her that she doesn't have a choice. it is one thing to put me through it. 29-year-old woman, but to put a that is inexcusable. and i would say that i am hopeful that we can come to an agreement, nonpartisan agreementac in our state capit, and restore abortion access so

continue my plans with my future and expanding my family because that is something i just really want to do but i'm terrified to do. >> american women deserve the to make our own decisions and mr. chairman, this side of the dice trusts women. >> senator lee.in >> thank you, mister chairman. start interrupt, senator merkley. >> i feel the need to point out something i think a casual observer might miss from some of the comments.no the dobbs decision did not criminalize abortion. the dobbs dio anything to affect the legal status of abortion other than to return the primary decision on abortion back to the states. it concluded this has always been an issue that was before the states prior to roe versus wade, the supreme court in dobbs hundred roe versus wade and sision that most of the time unless we

are dealing with something the district of columbia, military installation using government funds or something like that isn't normally going to be federal action. they returned it back to where it was. states have been more or less out of this arena for about 50 years. they had been out of the arena for 50 years, as most abortions are occurring in america couldn't be meaningfully restricted in light of roe versus wade and its progeny. states are getting back to that business after it had been usurped by judicial oligarchy of sorts for nearly half a century. states will handle this differently. states handle many things different. everything from occupatiol licensing to what procedures might be performed, even criminal laws of one state differ from those of another. those laws are made by men and women elected

of those states. sometimes those laws can end of having unforeseen consequences, sometimes tragic ones. from time to time but it is important to focus on what this is about and what it is not. it is at the end of the day something that is in the hands of the american people. it is part of what having a democratically elected government means. it is what it focuses on which i've heard several mentions ly made to the idea there suddenly going to be a national abortion ban, federal abortion ban and acted. to my knowledge, republicans who now control the house of not push for a vote on that. the born alive protection act as a different circumstance. if a child was born alivi would hope we can all agree regardless of a your religious moral, or policy feelings about abortion i would hope we can

all agree that once a child is born therens are all kinds of protections, allowing someone to be killed carries all kinds of other ramifications. mrs. ford, i would like you to talk to us a little bit about the marriage penalties that exist in our current tax code and our social safety net at the federal level and what harmful effect they might have on things like family formation, how do they harm, for example, married couples with children i in a way that doesn't affect other families? >> i would like to start by pointing out marriage penalties which exist primarily in the program explicitly like earned income tax credit, thousands more if you're unmarried and have children versus if you are married and have children but there are implicitly through the rest of our program if you don't declare who you are not married to within the home you can receive thousands more in

snap benefits or any other number of benefits. and the affect that we see this has had on our culture is within the unmarried birth rate. we have the highest percentage of children living in single-parent homes in the world. it is 1/4 of uss children in single-parent homes compared to 7% around the world. >> are you s thus incentivized out of wedlock birth and child rearing? >> the information is following that way because when we track cdc data if you are looking at college-educated women fewer than 10% or 11% have childrend out of wedlock, roughly some part of what was happening in the 1960s, when looking at less educated women it comes close to 60%. it does hit on education levels is going to be born out of wedlock and we know very clearly from the data that there is an impact to having

this is why most security's recent book the two parent privilege was published. data, there's a huge benefit to having two parent in the home with the child. >> how did that contribute to the perpetuation or exacerbation of existing inequities along racial, economic, and demographic lines? if there is a single mom who raising a child alone is more likely to expand its economic hardship and much more likely for her children to experience intergenerational poverty.xp the 60 years ta dependent -- economic outcomes, the program which provided cash assistance to mothers, by the 1990s, 9 of 10 women were unemployed, one in 7 children were on the program and after it was performed to focus on work the out of weblike --

women returned to work by 20 points and child poverty actors. when we incentivize the wrong things sometimes we get those things and those things can sometimes harm a lot of people, ly the most vulnerable, thank you, mister chairman. >> thank you. the order i have at this stage depending on attendancr merkle, senator padilla, senator kane, senator wyden. you could be bumped up the sequence. >>hank you. leilah zahedi-spung. if in some states, i want to understand, if an ultrasound reveals the fetus does not havs a heartbeat, some states, woulh it be basically the law now require women to carry that

child until there is a miscarriage, the child who does not have a heartbeat? >>no■w if any states that require people to carry pregnancies that are true miscarriages. what i can say is with procedure bands, it can require patients who experienced a miscarriage where the fetus has done that, to deliver that fetus and undergo an induction instead of having a medical procedure that could end their suffering quickly.■í >> that was exactly the situation we were in with our first child, we lost our first child at four months. i think it would have been extremely difficult for mary to be required by the state to carry that child past that point.t i want to turn, caitlin myers, the bull riders the house is proposed including riders that

restrict access to medication ó of abortion. what would be the economic impact of passing an appropriations bill with these extreme antiabortion writers? >> thank you for that question. the economic impacts could be tremendous depending on the rider but i woul method preston has become important to that even before dobbs, moree than half of all abortions provided were provided as medication abortions and write now, 40% of brick and mortar abortion facilities in this country only provide medication abortion. theid remaining facilities wit few exceptions provide ■h medication and procedural abortions. if nipper stone access were provision of abortion in this country.

it could end telehealth provision which is extra nearly important to people, it could shutter providers, brick-and-mortar providers s across the country including in states that have been supportive of abortion rights and might not understand thehe it would create limited appointment availability at many facilities that remain. >> thank you very much. leilah zahedi-spung come back to you, based on your experience in colorado with expanded access to abortion after the dobbs decision have you seen an increase in in the number of folks coming to colorado from out-of-state? we that question. we've certainly seen an increase in the number of abortion care the -- providing our group, has seen an 8 times increase in care provision in the last year and a half since the jobs decision. in addition to 40% increase in procedural abortion care that has been seen.

hard to quantify how much is out-of-state versus or patients needing the care and not being able to access it. >> that created delays in the state for women's access to reproductive care? >> certainly. certain number can provide this care given you have to have specialty training to do it. none of us ever want to delay a patient receiving necessary medical care, but there's only so many hours in a day when we can provide that care. >> it is reported as much as a thousand% increase in patients crossing idaho. mrs. phillips, thank you for sharing your story,g a story i could connect with, with my own family's experience, though not all the pieces of it that were so powerful. because of the restrictive laws

in tennessee, is it the case that your doctor was not even able to offer advice to you on how to obtain an abortion? >> thank you for the question, my doctor had taken an oath to provide the utmost care for her patients and at that point in e time, the way she understood nnessee's law was that she could not offer me resources. she stated that i would have to do the research on my own and that i was left to essentially defend myself and my life and my fertility. >> thank you very much, thank you, mister chairman. >> senator braun followed by senator padilla.ad >> thank you, mr. chairman. this question will be for tamra call. i want to preface it with these comments. colleagues before me have had

questions about the nature of life and human essence and i think it made the point but it's hard to distill that into economic terms. when you try to do it through an institution that is now become one that is -- has no p spending money from future generations just to tell you where we are there, this is the budget committee, we are now borrowing $1 trillion every six months, you know who's back that's going to be upon? our kids and grandkids. that's probably a more pertinent subject to what we are talking about here today but on the subject matter we've that is about as bad a business plan as anyone would ever want to be a part of. and here, to speak about this in economic terms.

from the state that i am from, this is a question of being pro family, pro mother. that would be be a place, i think the would be a legitimate place to have a discussion, just not trying to do anything about it if you are poor when you'rowing it from your kids and grandkids. indiana has effective public and private healthcare netrks that help women without urging them to destroy an innocent life. the general assembly's fulfill of indiana's culture of life includes the decision to disperse caniff funds to pregnancy care centers and alternatives to abortion programs. mothers should not feel alienated from forced into abortion, the biden administration embraces a or

cuure that wants to do the opposite, to strip support for pregnant women and their unborn babies. i think it is the wrong place to go. my question is what do you tell young families and worried mothers when they need help with an unexpected pregnancy should they be leaning towards that, taking the tools away from states that want to talk about life and preserving it, what is your opinion on that? >> you■fou repeat exactly what question you want me to answer? >> when you have young families confronting these issues what is your advice as opposed to what the biden administration has been pushing, take funds, money to facilitate ending the life. what should be the message?wh >> i believe the message should be that there are people here

who are very ready willing to support you, the state is ready and willing to support you. our local community is ready and willing to support you, i'm thankful in the state of iowa, they recently passed the moms program which providestate funding to centers like ours so that we can truly support these women where they are and w i wt to be clear, we never suggest should not do. we simply give her the information, let her know all of the resources available to her. as has been said, it can be tricky to navigate all the a systems and institutions and we are there to be her and to help her walk through that as she considers her decision. >> have you had any outreach from the biden administration >> 0. >> i think that is something if

you're going to try to push one dynamic, at least to be fair, it ought to be something you are willing to do with the other point of view as well. thank you.wevá >> senator padilla. >> thank you, mr. chair. then senator kaine. >> i wanted to lead with a couple data points. thank you offer your testimony and participation today, an important and timely conversation. about 42% of adults, up from 33% 5 years ago say that they have either used fertility treatments are personally know someone who has and there are currently an estimated 1.5 million frozen embryos nationwide. the recent ruling in alabama

effectively bands that in certain states because it would subject people involved in all steps of the process to unreasonable criminal liability. as republicans continue to stumble over the flawed arguments against reproductive rights, what i see happening is they are realizing it is one thing to say that you are opposed to abortion in theory, it is another thing to try to legislate in this new reality. personnel money house gop members lining up to pledge support for ibf while samuel tenuously signing on to so-called parenthood legislation with no carveouts for embryos in clinics. my first question, leilah

zahedi-spung, how would you talk about personhood legislation like the life at conception act?■v >> thank you for that question. if i'm understanding your question. the hardest part about all of this discussion is reproductive justice is about choosing when to have a family and h choosin when not to and how you choose to parent your children as well. the argument around ivf,ction around why abortion care is necessary medical healthcare is you are taking away the autonomy of families to make the decisions that are best for them and erasing grief and trauma for those families that are having to make decisions that are very difficult. having known plenty of colleagues and friends who had to undergo infertility treatment, that's a very difficult road for them and to

have their time and energy and responsibility taken from them by the state and told what they n can't do with a that is as scary as what we are seeing with the patients were coming to us for abortion care. >> i appreciate the perspective as a physician in this because for a party of claims to be t liberties they are taking aw rights and freedoms and liberties from families across the country. doctorrs, can you talk about the societal and economic impacts of banning ibf? >> i will preface it by saying, my oldest child is an ivf babyy and the product of a frozen embryo transfer. this same what is happening in alabama.

reproductive autonomy isn't just about young people avoiding parenthood until they are ready. it is about all people being able to become paren w they want to. ibf has helped millions of people including the and economic evidence suggests that it allows women to spend more time seeking the right partner, investing in education, investing in their careers. in a country and moment we are increasingly seeing people delaying parenthood, lack of access to ivf is very concerning. >> thank you very much.th if i can in my time remaining i want to touch on another topic because i think as leilah zahedi-spung exemplifies, across the country obstetricians, gynecologists, nurses that are leaving their practices in states like idaho, texas, oklahoma and tennessee

while new doctors are avoiding those st the departure of respectedndnt hospitals have closed their labor and delivery units in these red states. so the brain drain extends beyond maternity care. the jobs decision, growing number of companies have updated their health insurance policy to include abortion travel benefits and it is because they recognize the impact state laws restricting abortion care have on their ability to attract and retain talented. leilah zahedi-spung, you left georgia and tennessee as you sharing your testimony y as a result of dobbs and the state'r abortion restrictions. i can imagine republic and attacks are driving obstetricians and other healthcarenals from red states. how does this impact access to essential healthcare services,

including prenatal visits, including access to contraception, including maternal, fetal medicine and postpartum care, cesarean section and more in those states that are being left behind? >> thank you for that question is going to happen as these rights continue to be taken away. we know even prior to dobbs that states that had abortion care restrictions had worsening maternal mortality andte morbidity and that was still divided and worsened across raci lweos are adding the factt they are in states where there are significant abortion bands your laminating an entire workforce and in addition, almost 50% of the ob/gyn residents are training in states with abortion care restrictions. we now don't, we will graduate an entire generation of ob/gyns

to don't how to do miscarriage management. .. d&c's for care management and aren't able to speak to them about their pregnancies to provide emergency medical care in these communities i'm very afraid what's that's going to mean for their patients. idaho, for example, has had a multiple maternity wards closed over the last several years as almost 25% of the ob/gyns workforce have left and there's maybe two maternal-fetal medicine physicians left in the entire state. patients are traveling 200 miles one way for prenatal care now in a state thatta already had realy terrible maternal mortality and morbidity. i worry what that means for the residents of that state at how we are going to continue to watch women die. obviously we have debates as icalcymakers and we are seeing

professionals in states across the country but the ultimate consequence, and this is why you were having history, the ultimate consequences ares on women and families, and that needs to be the center of our actions here. thank you. >> senator kaine and then senator van hollen and less senator wyden return. >> ms. phillips come your tests but was incredibly powerful and want to thank you for sharing it. the legal system of dempsey in this country has really d you. i was listening to ms. call all your saints in h the work she tries to inform people try to be nonjudgmental and let them do what they choose to do. your state does not let you do that. your state does not let physicians do it. the fact that you have a physician has taken an oath to provide you patient care is so afraid of criminal liability or loss of licensing privileges, that when you were given this devastating news for you and your mom have to go online and

search to find aea place thousas of miles from where you live,, far away from, any family in the city you've never visited, if i remember youdvr testimony right, to terminate a a failing, failed pregnancy. i mean it's just the cruelty is astounding astounding i mean i just wouía like to and just click that piece of the testimony from ms. call earlier. we want to accompany women of the can decide what's in the best interests. if that's what healthcare provider testifies, why wouldn't a state legislature or a court system or congress have that same attitude? i want to push back a little bit on braun, he was pushing aligned the biden administration is interested in abortion and not on moms. so let me correct that. the american rescue plan was the first piece of legislation that was passed under theni biden administration in the 117 congress, and my colleagues and i were he and it passed by one

vote. one vote. every democrat voted for it, every republican voted against it. the american rescue plan included a really important provision for moms and kids. prior to it, medicaidld deliverr 90 days. more thanha half the births in this country or medicaid births. prior to the american rescuebs r 90 days. in the american rescue plan we allowed states to expande that0 days to a year with a mom gets covered for here becausese theye so many challenges mother's face postdelivery. that pass by one vote, democrats did that. republican voted agait mothers. they voted against mothers. done with that mandate. we extended it in an appropriations bill for nextt year, 45 states have decided to

embrace this optional mandate we allowed them to do, embracing the biden-harris policy, policys supported, and every less republican in the senate opposed. mr. chair, i imagine you've been here longer than me. there are dayss when you are hee and wonder if you were dng anything. then there are days when you hear something happens that one vote, the american rescuelan, moms get medicaid coverage. we stayed 2 million workers pensions, saving the affordable care act in august 2017, happened by one vote. inflation reduction act to bring down prescription drugs happened by one vote. the american rescue plan had another p-mom, profamily, pro-kid provision, the child tax credit that reduced infant poverty by 45% within six months, , passed by one vote. ev supported it. every republican opposed it. i gather from your testimony,

professor myers, one of the reasons one often cipher committing pregnancy is financial pressure, the financial pressure of health-care expenses, the financial pressures of raising kids in finding childcare. knowing that you're going to be covered for healthcare in the year after delivery, knowing you can get a child tax credit to help you with the expenses, these are the kinds of policies that are pro-mom pro-moy and might even help the u.s. deal with the declining birthrate and kind of turn it around, and we could start to have a growing birthrate against this fam cushion and thead financial pressure wasn't causing him to consider terminating a pregnancy. am i right about that? >> yes, i think you are, senator. thank you for the question. american birthrates have been plummeting, and the reasonsst ae very complex but i we should all be very concerned about that through multiple lenses, including a fiscalpl le. one of the reasons people give

for delaying becoming parents are having fewer children is financialen concern. and so i will agree with ms. ford that we could bolster the social safety net, we could reduce marriage penalties.. i think that's a really good idea. but you jus other financial concerns that affect families, and the childt tax credit was an incredibly important piece of the social safety net expanding medicaid is an incredibly important piece making welfare business morebl accessiblets, doing things like reducing child caps on them. the so many other things we need to do to bolster the social safety net, and in doing so we would likely help disconcerting trend of declining birth. >> thank you. i yield back. >> senator van hollen. >> thank you, mr. chairman,,. thank all of you for your testimony here tod. phillips, ie room but i cited testimony on c-span as theth hearing progressed. and i want to thank you for

being here and sharing your very personal story, and it does miley ros m were here speaking m half not just yourself but as you sit millions of other american women. so now you've experienced a senate hearing, lotsen of things havehe been said so i just wanto give you the opportunity as a close, i mayay be the last senar ask questions. after you've heard everything here today, is there anything that you would like to say in response? and make sure that we can correct any misperceptions that some people have expressed. >> yes.■y and thank you so much, senator, for giving me this opportunity. i will start by saying that i made a promise to miley better name would not die with her. so that is part of why my activismy is so important to me, is a people know who she is. i want toments

before i go into a final thing i would like the committee to know. i think it was senator kennedy came to this hearing noises going to be a mother here who had to make the difficult decision to terminate a 20 week pregnancy, and he decided it was in his best interest to show a fetus in his testimony was nothing but fear mongering. from my experience that was not my experience. what he was trying to persuade. also, ms. call, to answer your question to what he had asked, my procedure was an abortion. it is on my medical paperwork that i had an abortion even though my daughter was deceased. it is not back and forth. an abortion is a medical procedure whether that he does is deceased or not. but i would like to ask the committee to remember my story and remember that i am one of thousands if i not millions of people in this country that need for needed abortion access, and remember it's not black and

white and one size does not fit all. we can't be putting politics into healthcare decisions, and also remember the facts that abortion access is essential healthcare, thete matter how you want to look at it. it's essential healthcare for so many. andm exceptions don't work.mony. tennessee had a very vague exception to protect the life of the mother. my life was at risk and i did not qualify. i would a the committee to consider passing a law that allows access without exception just all b across the board, because when someone needs healthcare they should be able to receive that healthcare when they need it and not have to navigate the hurdles like i did. because like i said i don't know if i made it to new york if i would bee here with you today im very thankful for theun opportunities that i was given to get to new york, and now this opportunity to fight that we're facing in many states. >> thank you, ms. phillips. thank you for your earlier

closing.lo dr. zahedi-spung, if i could just ask youñ=e on the real challenges doctors face in trying to navigate these legale. senator padilla asked some of the questions i had planned ask about the doctors and the decisions to have to move to other states and how that leaves women in the workforce in states like tennessee at greater risk. but it's because doctors don't want to end up being fined or worse, for their actions. so could you, and i know from your testimony that you call upon youel physicians, when you in tennessee and others to try to navigate■; these thin, and how it's an impossible

standard. can you just talk about that, that kind of experience of having to go through these difficult decisions when people are talking about providing, opposing legal penalties? >> yeah, thank you so much for the question, senator. i'm a physician and not a lawyer. i did 11 years of training in order to become a doctor and and then along with it to affect that took my ability to care for my patients in a way that was necessary away from me, and from so many others. ii will never forget after the date after dobbs the number of conversations i had with our hospital lawyers, my criminal defenseaw attorney, the lawyers across the country who were tryingo-changing experience for patients and providers. and i wasn't able to care for patients because i was trying to figure out if i could even take o them. i had a hematologist call me and

ask if he could give chemotherapy to a breast cancer patient who he just found out was pregnant because he was worried that if he did and she miscarried he would go to jail for taking care of his patient. it was, it is still terrifying. we navigate this on a regular basis with patients who are coming to us with some very complex care trying to make sure they have all of the follow-up and care they need back home while still protecting their privacy. it's untenable, and i am devastated i had toeave place that i loved and a community that i care deeply coo any good if i wasn't able to practice medicine him in. >> thank you, doctor. >> thank you. >> thank you. thank you, mr. chairman. >> thank you thank you . let me thank all the witnesses. the was a comment,oume a critiq, professor myers, of your conclusions regarding the causal effect between reproductive care

restrictions and the economy, specifically the appropriate conclusions toyl be drawn. you have not had the chance to respond to that. i think in fairness i should >> i would, thank you, chairman whitehouse. i would like to return to that. i want to say first of all very clearly that most of the evidence that i present and share in my testimony is not from the turn away study. there is ample evidence multiple independent research teams using different natural experiment to isolate and measured the effects of abortion access. so we are not just talking about the turn away study by any mes. but when we are taught about the turn away study that evidence is causal and illustrate what are the most important studies to come out of that research project, i do want to be clear, it's not my, this is another team, took people who are in the turn away study, seeking abortions, and some of them are funny out that they were just

past the gestational age limit received the abortion that they wanted and they were turned away. and others were just under it and received that abortion. >> what's the name of the study. >> hence thee name of the stud. the researchers connected allf these people to their experience credit reports and they followed with a a credit report look le for months, years before this pivotal event in their lives,, and the twotw groups trended incredibly similarly. they looked really, really some right up until the moment that this happens to them, and that's when there's this incredible divergence and all that said the people who are turned away at this enormous increase inffense. i don't think a reasonable person can look in that evidence and say that's just a correlation, something else happened that day that caused their credit to fall off the cliff. >> are right. thank you for that response. for your testimony here today. i know that ms. phillips, this

was particularly difficult for you and one of our call is made even more difficult, and i apologize for that but i thank you very much for being here. the record will remain open in case anybody wishes to anything for another week. but with that, this hearing is concluded.ti [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations]

>> jordan kearny who covers congress for political report hunter biden legal team has informed the house oversight committee that he will not the attending a public hearing that the scheduled for march 20 and a committee chair james comer hunter biden attorney blamed the scheduling conflict for his inability to participate before criticizing the committee's ongoing impeachment inquiry into president biden. last month hunter biden was on capitol hill for a closed-door deposition that lasted several response mr. comer released a statement saying in part the house oversight committee has called hunter biden's bluff. for months he wanted a public hearing but now that one has been offered alongside his business associates, he is refusing to come. next weeks hearing is moving forward and we fully expect hunter to participate. >> today on c-span health and human services secretary xavier becerra testifies on president

biden's 2025 budget request for his agency before the senate finance committee. live. live coverage at 10 a.m. time on c-span2, the senate is back to consider the nomination of a u.s. ambassador to haiti. later in the day senators will also vote to advance the nomination of a judge for the fourth circuit court of appeals, emergency management officials testify on wildfire preparedness and response efforts before thev senate homeland security and governmental affairs committee. you can watch our live coverage on the c-span lbd or online at c-span.org. >> c-span now is a free mobile app featuring your unfiltered view of what's happening in washington live ademand. keep up with the big biggest events with live streams of floor proceedings and hearing some u.s. congress, white house events, the courts, campaigns and more from the world of

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