have multiple committees on which we serve in the senate and from time to time it's important to check in with those committees. senator barasso will be along and i'll make my opening statement and then i will introduce the first three witnesses. senator grassleyey will introdue

a witness in senator lee will introduce a witness and we will proceed. we are here today to discuss women's rights, the right to bodily autonomy, the right to set the course of their own life and their right to economic freedom. i hear off in the budget committee should only be concerned in deficits but in a serious conversation about debt and deficit must analyze threats to economic growth and ability. deficits do not occur in a vacuum. welcome. they result from a fiscal decision that we make and from what we do. it it strengthens or weakens our economy.y. reproductive rights it turns out are intrinsically tied to economic opportunity. reproductive justice is economic justice. restricting one restrictsin the other. as professor myers the leading

economists will testify today we can measure the economic harms for dismantling roe v. wade especially in already marginalizedad communities. the dobbs decision triggered an immediate crisis for millions of women and antiquated state band snappedta back into place in soe states implemented new restrictions on reproductive freedom. our witnesses doctors zahedi-spung will explain how puts families into heartbreaking situations. about 25 million women of reproductive age within states with severe restrictions on abortion. most in states that fail to expand medicaid and already have higher rates of maternal death. black women are disproportionately affected as many that inin southern states with restrictive policies with

existing structural barriers to care and with already high rates of pregnancy related complications and death. doctors lose their freedom to practice medicine as they are trained. delivering patient centers evidence-based care. thi hear from rhode island ob/gyn's about their colleagues in other states being put in impossible positions. the lives of women and babies 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. as the pivotal study found women denied an abortion and were forced to carry it.

to determine were four times more probable to live in -- in abortions and contraception lowers maternal mortality alleviates health risks increases women's earnings, increases the probability that women attend college and boosts local economies. freedom turns out to have economic -- and planned parenthood we looked at the economic -- were part of the courts holding the court said the ability of women to participate equally in the economic and social life of the nation has been facilitated by their ability to control their reproductive lives. economists and researchers have quantified the damage of state abortion restrictions to local and state economies in the correlation is easy. the more extreme the state's restrictions the more its economyom suffers.

a new study estimates abortion restriction cost the national economy on average $173 billion per year. in overturning [roll call vote] and casey a small right-wing majority have of the captured supreme court inserted the government to the personal life decisions of them millions of women moving that freedom never minding the consequences. this is a court with members on a mission. that freedom fell at their hands. next maybe the freedom to take mifepristone and abortion medication long proven safe and effective the for next come the freedom to use contraception. even in vitro fertilization is under the gun at the hands of right-wing extremists. a republican-led congress and the second could mean in national abortion ban. if selected trump could use

executive power to remove mifepristone from the market or try to prevent abortion medications or even contraceptives from going through the federal mail. republicanai effort to ban mail order medication could cause even larger problems than dobbs. women fought foror their freedos to make their own personal decisions but theyan fought in their -- they wanted their picture brought economic gains but now stream as are trying to undo it all leading young women and girls with fewer rights than their grandmothers. womenan and girls have lives woh respecting and protecting and no one should be forced to carry a pregnancyfo to term against ther will. women ofll the freedom casts a long shadow over their lives and over their families lives to cast a long shadow over our economy as well pick on as well prikhadko should safeguard access to abortion and contraception and codify roe

into law but but this is somethg women should decide. it's not the government's business and i will now turn in -- turn it over to ranking member of barasso. >> i'm sorry a litmus the last three hearings. >> it's great to have you back and be healthy enough to be back. >> 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 has not delved into 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's rather dehumanizing for the chinese communists are an example of this instituting a one-child policy. targeting female babies to extermination and they did this thinking it would help their economy. look what happened. now the chinese realize it's backfiring and hurting the economy. i think right now the statistics show they are no longer the largest population in the free world being supplanted by india. look at western nations like

their r own. we are also realizing we need more people to sustain the economy and protect social security. i guess that's one reason we are the most immigrant welcoming nation by taking 1 million people legally every year into our country. so yes, having and raising children has costs but so does abortionio on demand and a culte that respect for life. that said, here we are. i am pro-life, pro-family, pro woman. these views are not in conflict. what areti the alternative to abortion that exists in the rare circumstances. numerous programs to get the federal state and local levels are available to help women and

children and families inin need. to better assist families congress should focus on reforms that increase coordination between all the federal programs that we have. congress should simplify access to these programs. it should reduce duplication promote work or education and eliminate penalties in our tax laws. for years i have championed supporting bonds m and kids. i've worked to support and approve our adoption and foster care systems. i've long been a strong supporter of tax incentives and lawsnd to promote adoption and reduce financial burdens associated with adopting a child. as in chairman obey tax finance

committee now 20 years ago i helped shepherd the bipartisan pass -- tax relief program that included updates on the adoption tax credit. additionally i'm a member of the congressional coalitionng on adoption and founder and cochair of the senate caucus on foster youth and have worked for years to improve policies and support for those who open their hearts and their homes to children in need. i'm also an advocate of the early childhood home visiting program which serves many mothers and children across iowa and other states. it's critical that we support the most vulnerable in our society and this program has been a successful tool to improve the livelihoods of that risk families. this congress i've introduced

the bipartisan healthy mom's and babies act with senator maggie hassan. the bill was the culmination of my work in the finance committee chairman where i selected ideas from stakeholders including iowa health care providers and advocates on ways to improve maternal childcare. the public is debating many abortion issues following supreme court the decision but today this committee will hear from two witnesses who will tell us about the types of programs supporting pregnant women and families. we will also hear from folks in communities that stand up by their neighbors to let them know that they aren't alone and they have options. that's the type of message

everyone can get behind. thank youou mr. chairman and thk you to the witnesses, all of our witnesses for appearing today. >> thank you senator grassley and again welcome back. our firstom witness today is professor subfive of middleboro college. professor myers is a micro, as he uses physical methodology to measure the causal effect 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 open framework. dr. myers thank you for being here. next it will hear from doctors leilah zahedi-spung.

dr. zahedi-spung is a board certified ob/gyn in maternal fetal medicine physician in colorado. she received her bachelor's degree in biology from the university of georgia and her medical degree at -- university purchasers as a member of the reproductive health committee and a member of the education committee through the society for family planning. dr. zahedi-spung welcome and then we will hear from allie peterson. she is a tennessee tennesean a mother and an activist. she shared her heartbreaking abortion story on line. she turned her pain into polished -- policy. mrs. phillips we appreciate very much taking the time to join us. i will now turn to senator lee and ranking member grassley.

>> i have the privilege of introducing an iowa from story county,nt iowa. ms. tamraa call and msn and are in. she is executive director of the medical planning and aims to iowa.. she's a fully licensed community care clinic that provides professional medical services including consultations, well woman care, pregnancy testing, ultrasound, health education. it employs board-certified ob/gyn physicians, registered nurses, nurse practitioners, medical assistance and support staff. mrs. call holds a bachelor's

degree in nursing and a master degree in public health from the university of kansas. i'm also pleased to welcome her daughter to her hearing as well. thank you both for beingng here. >> senator lee give an introduction to make quick >> thank you it's an honor to privilege to bee able to introduce one of our witnesses today. leslie is an adjunct fellow at the american enterprise institute and the center forut opportunity and social mobility. she'sls also president of an entity called for policy solutions and a member of the state of virginia's department of social services, state board of social services. she is authorized to adopt and recommend policy solutions on various social programs within the commonwealth of virginia she

is personally served in the white house as a domestic policy adviser and a special assistant to the president from 2018 to 2020 work and i'm to social safety net programs and the administration's antipoverty agenda. most importantly it's a great opportunity to introduce her into endorser because she's a former member of my staff but she served as a policy by his or in my office where she oversaw policy portfolio, health education and worked on the development of a wholeel lot of social safety policy bills and amendments and helped put together groundbreaking legislation in the number of areas including in education reform, welfare reform just to name a few. she has the force moved on to become a thought leader than

someone who has contributed to the meaningful welfare reforms in antipoverty measures. i look forward to hearing from our witnesses but especially leslie for today. >> thank you senator dr. myers please proceed. chairman whitehouse chairman whitehouse and member of the committee thank you for the opportunity.se my name is subfive and i'm a professor of economics. as a labor economist i study the probable effects of contraception and abortion access on economic outcomes. i'm not here's an activism here's a scientist visiting facts and evidence on the way in whichec reproductive policy is fundamentally economic policy. women make up nearly half of the u.s. labor force. their increased work hours and earnings since the late 1970s have listed the us economy by 11% and prevented middle-class outcomes from thisco decade.

men and women's earnings were similar up to the point of parody but when they become mothers women declined by 30% and open a gender gap that persists. which is the gap is explained bi the challenges women face in working motherhood and it's exacerbated by the lack of paid family leave and the high cost ofav childcare. of course course none of this applies that women don't benefit greatly from children. i'm a mother for it in for a time i was a mother of -- sure it's worth it to me and decision i would make again but that's the point. trey dopson decisions about whether and when to become apparent are inherently personal and closely tied to our economic lives. even the best laid plans of mice and men and women go awry. abortion is the comment health

care need. before dobbs nearly 1 million pregnancies ended in abortion each year. that's about 20% of all estimated pregnancies. at that rate a quarter of women will obtain a abortion in their lifetime and when they do they are often in voepel situations. most are young mothers in nearly three-quarters are low income more than that reported a recent event like the loss of a child. the reason women site for abortion relate to aspiration and abilities to care for the chill but but this brings me too points. access to contraception and abortion empowers women to plan their economic futures. it goes hand-in-hand with women's economic progress but the introduction of e the birth control pill and 1960s followed by the legalization of abortion in the early 1970s the company to period of ethical social and economic change marked by women's gaining

education, strengthening attachment to of labor forced entry new occupations in increasing their earnings. we all know the correlation isn't necessarily causation but in this case is. ample evidence from multiple independent research teams who have the physical tools to causal tools and measure the effect. the legalization of abortion rewrote the men's wives and reduce motherhood by one third and -- a reduced maternal mortality black woman by 30 to 50%. let them to complete their education and increase their earnings and in doing so improves the lives of children reducing the number living in poverty andli the number experiencing abuse or neglect. these children themselves at higher rates of college graduations lower rates of single parenthood and were less likely to be poor. it's not as though the failings

of abortion access is gone away. when city fines as was the of being denied aa wanted abortion women experience a 70% increase -- an 81% increase in adverse credit reports like evictions in bankruptcies. since the dobbs decision 14 states are forcing your total abortion bans in nearly a quarter of american women increase their travel distance to their nearest provider for the average effective lemon faces a journey of more than 300 miles one way. if any of my kids needed health health care treatment. also i attack them there tomorrow but not everyone has the such a privileged position. i grew up in burnsville west virginia and i know many people who take multiple days off in short notice is not not possible but you don't need to rely on ant to go. as much as a quarter people seeking abortion cannot find a way to travel hundreds of miles

obtain one in especially true for young women and women of t color. even those who do make the trip appointment availability is constrained as many of the facilities on the front lines to receive them. the first set of post op exams results in about 30,000 births in 2023. they would not have occurred. theseba children are likely born into some of the poorest and economically fragile families. any of which contain other children as well. right now the dobbs stories and inequality story. depending on future policies this could change. if abortion is further restricted if congress were to enact a national ban we'd be playing the 1970s in reverse. .. abortion abortion 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 december distinguished members of the committee. i am a board certified i am a board certified obstetrician gynecologist, and complex family-planning physician. i provide high-risk obstetric care clinic ultrasound genetic testing, perform deliveries and provide abortionli care. i'm here if there isti a fellow with the vision for reproductive health. i'm also felt it was a saga for maternal fetal medicine american college obstetricians and gynecologists i'm a brown woman he passes as white. the child of a first-generation immigrant for the middle east. i'm mother and a proud southern script was trained in the southeast ex- shirt cared for that community for the majority of my career. i became a doctor because of my commitment to care for people without judgment of the course

of their life. whether i'm caring for someone who's ready to buildld or creata family, already parenting, leaving due to an unexpected diagnosis or caring for someone who does not want to be pregnant, all of my patients have something in common. they are makingie thoughtful thdecisions about their health d well-being deserve high quality health cared regardless of who they areeg or where they live. i want to be clear today abortion is life-saving, necessary, compassionate essential healthcare should be available throughout pregnancy. i have the honor of caring for a number of families who needed abortion care for a range of reasons for all of them medically necessary. i walked that journey with them they're so thankful to access abortion care in their community. since then i've heard from a number of those families about subsequent pregnancies that lead to healthy babies at the right time in their lives for them. unfortunately, the supreme court decision in dobbs overturns a constitutional right to h abortn wreaks havoc on communities across the country.

it wreakseo havoc on the lives f people seeking care and the physicians doing their best to care for their community. this is also true for myself and my family. after finishing my fellowship at washington university in st. louis are so incredibly excited to back to the south to care for my community. shortly after moving to tennessee as only position i was trying to survive abortionth ca. break the ice get taken care of emergencies f tennessee abortion ban at one of the most extreme bands in the country went into effect.th this band did not have any exceptions not even for life-threatening emergencies and post severe criminal penalties. it became clear quickly i can no longer provide the care at my patients needed and deserved without facing significant risk to both myself and my family. one of the hardest decisions i've ever had to make my family andnd i decided to move once agn

to colorado. the reality is i am not alone. many providers have been per shift care or services provided relocate or cease offering care altogether but as a physician in colorado i am still paying first and the consequences of this moment in their far-reaching. i am able to provide care for people based on what patients and i decide together is safest and healthiest for their lives without political interference. but so many patients who travel to us do not have that option at home. states continue to ban abortion patients areg having to travel further and further away from their home and communities. not only for their abortion care but for all types of primary and preventive care. while i am grateful to be able to care for the people who i cannot help but think about all the people we know you have been forced to remain pregnant do not have the memes and resources to pay for the travel, childcare, additional time off from work or keep up with increased cost.

we know from recent date is already thousands of people have been forced to remain pregnant from the dobbs decision this is exceptionally dangerous given the stateon of maternal morbidiy and especially for people of cover color. ifor consequences when someone s denied an abortion because even before the supreme court decision, it was incredibly difficult for many people to access his care. studies have shown us people are denied and abortion are more likely to fall into poverty, increase their amount that thatt generally have worse financial security for years following their abortion. inability to access has severe consequences this is especially true for black indigenous and people of color if a systemic racism in all aspects of their lives. we cannot forget how collective security benefits all of us abortion care restrictions harm our communities as a whole. despite all of these threats i am unwavering in my commitment to support people in my home and community in every way i can. it should not have to be this way people should be able to get

care in their own communities in a manner that is best for them with the people they trust. i urge you to listen to the stories being told today by the people who provide an access abortion care i hope these stories help you understand abortion care is not an isolated political issue under seal pro per family restriction on abortion access harm all of us and the people that we love. thank you for having me. >> thank you very much doctor. this is phillips please proceed. white house, ranked member grassley and members of the senate budget committee thank you for inviting me here today my name is allie phillips i live in clarksville, tennessee. my husband, brian works for a forklift company i run a small daycare out of our home. together we are raising adderley my 6-year-old daughter. we are not a wealthy family we work hard to pay our bills on time each month. i spent the first several years of her life as a single mom working three jobs while also finishing up my bachelors

degree. ryan and natalie and i are excited to learn i was pregnant in the fall of 2022 and even more thrilled to find out we were having a little girl. miley rose. everything is going perfectly until theom day of my routine anatomy scan. at 19 weeks, my doctor told us that the multiple concerning fetal issues, several days later i waited to meet the fetal specialist, i had no way of knowing the next 10 minutes would change my life forever. that fetal specialist came into go over the results that list was extensive. miley's kidneys, bladder and >> were not functioning. only two of the four chambers of her heart were not working. there is 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 told that miley was not compatible with life.

completely broken i asked what do we do now? the 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 healthcare. my second option would be to continue my pregnancy but risk a miscarriage, a stillbirth, or giving birth for her to put right in hospice care. and then the doctor warned the longer i stayed pregnant the worst miley's condition would get the more at risk my health would become. knowing i had a daughter and a family to live for he made the difficult decision to seek an abortion. instead of grieving this devastating news, my mother and i began researching and calling clinics and states that allowed abortions after 20 weeks. many did not have open appointments for weeks the longer i waited the more extensive 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. way to quickly figure out how to afford all of this. we did not have thousands of dollars sitting in our bank accounts. i had to start a gofundme effort without help of strangers on the internet on the freedom to be tennessee or my own medical decision. days later i arrived at a near exceeded clinical and due to security concerns only patients are allowed in. ultrasound showed her heart was no longer building -- beating i am sorry. >> take your time.

i calledhu brian my husband to tell him over the phone are much wanted daughter was already gone and that the abortion scheduled for the following day would be done immediately. i went into surgery alone and i sat in recovery alone. i grieved her loss alone in this city i have never been the end, far away for 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 it not criminalize abortion. the standard of care that i needed in my situation. two days later i flew back home to tennessee for it had to go back to my life like nothing ever happened. i have never felt as small and

inconsequential or unsupported as i didns then. i was so depressed i could not go to work for another week after we got back. we lost three weeks of pay which is rougher family that lives paycheck to paycheck. we did not lose our home. we want to have another child. but we are terrified because tennessee still bans abortion and criminalizes doctors for providing essential healthar cae for pregnant patients. thank you for letting you honor miley's memory by sharing her story today. millions of people live under these laws just like tennessee's r. and i know i was lucky to get the care i needed. but no one should have to rely on luck to get essential healthcare. we must have a right to access that federal healthcare we need to matter where we live or how much we earn. thank you.

the next witness is mrs. ford? white house ranking member grassleyey think of her the opportunity to testify today i met fellow at the center for opportunity and social mobility of the american enterprise institute. my research focus on helping vulnerable families to find pathways out of poverty and opportunity. like to make three points about vulnerable mothers experiencing normally an unplanned pregnancy. first, many women considering abortion faced significant challenges. but abortion is not the answer. we've a duty to focus on real solutions. we should hesitate to make policy based on research that says abortion results and better outcomes for women including the turn away study scientific difficult to isolate the effect of an abortion on women's long-term outcomes at best the studies only point toot

correlation. we should not draw conclusions from them. instead we should focus on the fact we need women to consider abortion. nearly nine in 10 women choose abortion or unmarried. over half of them to choose abortion or in their 20s another 8% are in their teens. many women who seek abortion do so because they fear economic hardship. a majority of post- abortive women say they chose that option because the expense of pressure to abort from the important people in their lives. we must address the socioeconomic challenges that push them toward abortion. this leads me too my second point this safety net should be reformed to address many of ther challenges that women considering abortion face it. the safety net does support vulnerable low-income mothers givingin them food assistance, cash assistance, health insurance and in many cases housing assistance and childcare. yet despite good intentions the

safety nets often is the path of self deficiency and broadly discourages even though women it's the best way for moms to break the cycle of poverty and a key indicator whether their children will endd up in poverty as adults. major programs have benefit cutoffs are phase outs disadvantaged couples. in other words the traps to bump poverty by discouraging work in marriage the safetyth net should be reformed to promote with social scientists call the success sequence. this is at completion of at leat a high school education, full-time employment and marriage before welcoming children. even when unplanned pregnancy is a mental benefits after giving birth. when following up with mothers 15 years after nonmarital birth there is nearly 70 percentage point difference at the likeliness of poverty those who complete the milestones and those who do not. we can't and must do more to

encourage these mothers. my final point is the government cannot do everything. mothers need the support of their community. this means child support services must do even more tous ensure noncustodial fathers contribute to thent child's nees we should also engage nonprofit committee partners that support women through and after unplanned pregnancy. i would like to highlight here more than 2700 pregnancy resource centers nationwide provided wraparound services for mothers in crisis. including essential care from cribs to housing and so much more. i want to conclude by reiterating unplanned pregnancies present real challenges from others when abortion is the answer we can and must support these women empowering them to overcome the challenges they face. reforming is a crucial step like every american low income mothers deserve and desire real opportunity for themselves and their children.

what's absolute essential to support mothers with the power of community alt mothers, particular single mothers deserve a consistent and supportive community help movement welcoming children toen the world and giving those children the brightest future possible. thank you and i look forward to answer your questions. >> thank you very much. next. >> think you chairman white house, ranking member grassley at the other members of this committee for giving me an opportunity to testify today. i'm executive director of opiate medical clinic. our mission is to provide reproductive health care and support women in a way which empowers them to make informed life affirming decisions. ames is home to ohio state university 30,000 university students. i also want to note there are several medical clinics run our country. has been certified accreditation

association for ambulatory healthcare or aaa ac which accredits outpatient clinics because surgery centers and college studentte health center. certification aaa reflects a dedication to high quality healthcare. we operate in compliance with all pipit laws and our clinic is staffed by an ob/gyn, nurse practitioner, radiologist and highly trained registered nurses appeared at obira we have the privilege of working with smart, strong and resilient women overwhelmingly the need we communicate to staff is not much different than what t t we all . healthy relationships of people who will support us without judgment and empower us on the journey to be successful. turn to provide healthcare services at no cost including pregnancy testing, early ultrasound imaging, monitoring for possiblee atopic pregnancies or miscarriage provided a medical and emotional support as

well as after abortion care. we see hundreds of women at obira every year. women who are in college and afraid they'll have to drop out if they choose to carry their pregnancy. some are professional women who already have children but were not planning to have more. some women are struggling to make ends meet adding ain child feels impossible. others do not have support from the father of the baby. i am extremely grateful and humbled to have the opportunity today to share a story that is a representative of the hundreds of womenr we have seen at obira her name has been changed to protect your identity i would like to introduce you a sheet move from pakistan to the united states along with her two young children for a job at iowa state university. she made the move because her husband was not supporting her or her children. ace's husband came to the u.s. to visit the children and during this visit she became pregnant. she knew her husband would not

provide support she felt very overwhelmed at the thought of caring for three young children. she felt an abortion was her only option. she scheduled an appointment in our clinic to get more information about the decision she needed to make it. the nursing staff performed a pregnancy test and provided her with information about abortion, adoption, and parenting i have copies of those with me today and am happy to share them with you. the staff listen 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 her job but i was a at at i. obira provides numerous support services and referrals for women. obira is a qualified entity in the state of iowa which are

bright presumptive eligibility insurance, this means prenatal care is covered immediately while the full medicaid application is being processed. obira assists women and applying for a wick, the supplemental nutrition assistance program the family assistance program in iowa and childcare assistance. the state of iowa has a live map of childcare providers and openings. obira connects women with housing resources. we provide women with referrals for childbirth classes, parenting classes, early headar start in parents as teachers. obira offers a community moms group to foster connection and support among women with young children. we also have referral partners to assist women with ability, applying for jobs, basic finance classes, transportation needs and medical care. a woman should never feel abortion is her only option. when a woman walks into her clinic she often feels abortion is her only option.

the staff at obira prioritize open communication allowing the woman to actively participate in her reproductive health care decision. 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 and making an informed choice but also it reinforces her autonomy and empowerment and navigating her reproductive journey. the information and relational support a woman receives at obira instills in her the confidencece she needs to be successful. most of our clients when they choose to carry their pregnancy or not return to obira for care. what starts as a positive pregnancy test ends in a trusting relationship where we can provide support to women for years. thank you. >> thank you. i think it is a bit of a human

experience that when extremists want to take away rights and freedoms they speak in platitudes and generalities and jargon if you will. ngso mrs. phillips, thank you vy much for bringing home the real, immediate and practical consequences on that on your particular family. obviously it was horrible for you i understand is a pretty difficult. period for brian andnatalie as . >> yes and thank you again for allowing me too share my story. brian is not natalie's biological father he is her stepdad he was beyond thrilled to have his first biological child. at elite as an autistic adhd child full of energy and spunk

has always said when she grows up she wants to be a big sister that's what she wants to be and so she was over the moon excited when she found out i was pregnant she would sing to my belly every night trinkle twinkle little stard and would make little toys for her sister to have when she was here. trying to explain death to a then 5-year-old is already hard. trying to explain death of an unborn fetus, unborn baby is even harder. i had to explain to her that miley was very sick and she was causing mommy to be very sick we had to let miley go in order for mommy to stay. and as hard as it was she understood that she needs her mom and her mom potential if we decide to trade again later on down the road, it was very hard for our family. as a matter fact i am in that

year mark of what happened marcw york city. february 24 was the day i found out it was not compatible. it's very hard for me too be here today. to talk about it but i know how important it is because my experience is not exclusive it's not unique. millions of women face i what io every day. >> and your testament you used a phrase the standard of care which is a medical phrase i would like to turn to the doctor to describe a little bit of what standard of care means in the context of mrs. phillips experience? and discuss a little bit if you will the conflict that this extremism has created with the established medical care for

certain situations. in a laws that have been forced onto these families. >> thank you so much german white house. and for that question. standard of care is a phrase that'set used within medical societies in order to determine what is it best to take care of a patient. how we move forward, with the evidence supports, what science supports. in this situation it like what mrs. phillips went through standard of care is a deeply personal decision for what that family once. but ultimately when we have a pregnancy that's not going to result in a live birth the risks of continuing that pregnancy far outweigh the benefit of continuing yet for many families because of pregnancy we already know we are one of the few industrialized countries that

have is very necessary health care in order to provide the standard of care. not to mention the same procedure that is to use, a dnc for abortion care is also used for miscarriage management. during my time in tennessee, because of the way the law was written atopic pregnancies, treating ectopic pregnancies which are pregnancies that are dangerous and life-threatening because they are outside of the uterus was technically an abortion in the state of tennessee. you had providers who were deferring care that was lifesaving because of their fear of criminalization. when some as a water brakes early it's to end that pregnancy because of the risk to the pregnant person. we have evidence across the country including places like texas if you continue a pregnancy whether water is

broken you increase their likelihoodth of morbidity and mortality fivefold. >> senator grassley? >> i will start with mrs. call. your clinic provides a postabortion care. could you tell us a little bit about the care for these women and include the types of medical complications and emotional hurdles thatat abortions in thee women can experience? >> yes, thank you, senator grassley. when a woman initially comes to our clinic, one thing we prepare them for is what the abortion procedure will until we give them factual information on them. we let them know these signs and symptoms of complications may be so they know what they need to seek care after an abortion. we have had it women come to us that are continuing to have pregnancy symptoms after an abortion we will provide that with an ultrasound to check for

any public that abortion and if there are they are at risk for infection we will treat 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 a difficulty in their relationships. we once had a woman call us after an abortion she was struggling with feelinghe suicidal. her family knew she had had an abortion they are supporting her but she did not feel like they fully understood our nurse was able to connect with the resources to help her as sheh worked to the emotion she was experiencing following that abortion. we also have women who come to us after an abortion or a miscarriage and they say they just felt completely unprepared for the products of conception i would pass in their home when

they see limbs and faces and eyes and their bathrooms at home they are shocked and grieved at the loss of the child they were carrying. >> mrs. afford, you made a point in your testimony about our b safety net system being disjointed and difficult women and new mothers to navigate. are these programs and agencies thatic are more complicated than others? and what can agencies currently do to make these programs easier for women to navigate? thank you ranking member grassley. yes, i would say it women normally experience that's deeply fragmented if they a are looking for food assistance they go to one agency if they're looking for health insurance they have to go to another agency and usually fill out a different application. if they are looking forse help turning away from a situation with domestic violence that is again a different application it's a different caseworker. if they were looking for

assistance to get back into the workforce and we are that workforce innovation funding it is again not just a different application but a different location. fi would point to the state of utah as being most fully integrated states for their departmentse of workforce servis has integrated more than 50 federal programs into a single agency. caseworkers are empowered in the state of utah to be able to connect the person in front of them to any one of 50 programs that fits their needs and they are eligible for. most estates are not able to do that. even in the state i serve in 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 systems to access the services to treat the circumstances that normally one family would face. so, looking at integration should be a top priority to assist families inin need.

>> ms. collins got a minute plus for you to maybe take any time that you did not have time in your five minutes to tell us anything else the committee ought to know about your work with helping women who are pregnant or want to be pregnant. >> yes, thank you. no retirement economics today 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. r clinic with a 3-year-old son already. she was -- her and her son were living in her car. she did not want to bring another baby into that situation. so she >> and so she felt, again her onlyabortion was option. but after meeting with our staff and being listened to and heard and understood, the staff was able to give her information about adoption which she considered but decided not to choose. but then also was able to help

her find housing in our community, help her to get on to wic, to apply for medicaid, to receive food assistance. and when she has those resources, she felt empowered to carry her child. and we have the pressure of -- 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 week he -- we were able to help him find a job that has physical benefits -- full benefits and will enable him to provide for his family. so we are able to be that 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 a difficult situation, they want to keep their children, and they just need the resources to be able to do that. and the network of people around them who will support them and

walk through that with them without anyro judgment or shame. thank you. >> thank you. >> thank you, all of you who are witnesses. i am particularly grateful that chairmanan murray is here becaue she's at the point of trying to head off a house republican-caused government shutdown. so theve fact that she's here is very significant. chairman murray. >> thank you very much, mr. chairman. i really appreciate your having this hearing today. you know, since republicans overturned roe v. wade, reproductive rights have really been under attack like never before in our country, and i'm really glad that we are here today to talk about something that doesn't get enough attention. and that is the strong connection between reproductive rights and economic security. because when republican politicians take away a woman's control over her own body, they're also taking away women's ability to plan their families, their finances and their futures

on their own terms. the connection is more painfully if clear than ever in the post-dobbs america where your ability to get an abortion depends on where you live and whether you can afford to travel out of state. can you take the day off? can you afford transportation if? do you have a place to stay? do you need childcare? mrs. phillips just described all of that that happened to her. and there's a deeply cruel irony faced by women who are unable to geto abortion because of cost. women who are forced to stay pregnant by with republican politicians. if someone cannot afford to get the health care she needs, what do they think is going to happen henn she's forced to have that when she's forced to have that child? republicans' anti-abortion extremism doesn't just mean forcing women to stay pregnant, ultimately it often means women forced out of the work force and into financial hardship with no

support to speak of. here we are where where republicans want women to stay pregnant, but they don't want to address the childcare crisis. they want to force women to stay pregnant, but today house republicans want to not fully fund wic. republicans want to force women to give birth, but they don't want moms to have paid leave so they can recover from childbirth and spend time with their newborn. so it's pretty clear that republicans want to force women to stay pregnant but won't lift a finger to help new parents. i want you to know that democrats are working hard to help make sure women are able to decide when and how they start a family, and we actually support those programs. that families need. that is a pretty big difference, to me, mr. chairman. mrs. phillips, i want to start 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 there, probably thousands, who are facing the same choices you do. you're sitting next to a witness who just described a totally different scenario that doesn't even apply to you and wanting a rule of this land that will keep you from getting thing health care you needed. and 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 abortions such as you with had to do? through no want in your life but because that's what happened to you and what that meant to you and your family when you were forced to bout of -- out of tate all alone? >> yes, and thank you so much for the question and the opportunity to continue to speak on my story. finish i will start by addressing the committeeta by saying pregnancy isn't a one-size-fits-all situation.

every pregnancy is different. every reason to need an abortion is different. what my fellow witness explained did not apply to my situation. this was a -- [inaudible] pregnancy, and unfortunately for us it wasn't in the cards for us to bring that baby into this world with. and as a low income family, as spoke, i was a single mom for the first three years of my daughter's life. i took two weeks off of work when she was born unpaid and had to go back because i didn't have any other option but to work to take care of my child. i actually started the in-home day carat my home to be home with miley because we couldn't afford the infant childcare 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 it did, because without the help of complete strangers i would not have made it to new york. i don't know if i would be

sitting here today talking to you. >> thank you. i really appreciate that. >> and, dr. myers, just in the last few second ises i have, women of color, especially black women, this is really worsened longstanding inequities that they have faced. can you talk about how abortion bans andon restrictions have created new financial burdens for women, especially women of color? >> yeah, thank you for that question. everyes single study of which im aware that ice lates and and measures the effects of abortion restrictions on people's lives finds that women of color experience greater effects of those restrictions, experience those restrictions as greater barriers than non-hispanic, white women. the reasons are complex. women of color, particularly black women, have high era rates of unintended pregnancy, driven by lower access to contraception, lower access to insurance, also waste and poverty interact in complex ways

to create greater financial barriers like traveling, taking time off work, accessing childcare for women of color x. so we often see much greater effectss on that population. >> thank you very much. thank you, mr. chair. >> senator kennedy, then senator stab now. >> thank you, mr. chairman. professor myers, you're here at the invitation of my democratic colleagues, is that d right? >> that's correct. >> okay. in his opening statement, my good friend senator whitehouse said, and i want to quote, reproductive justice is economic justice. close quote. do you agree with that? >> i might if as an economist use the word rights, but, yeah, i do agree with that. >> okay. that's not true for the baby, is it? >> well, first of all, i would referrs to a fetus, not a baby -

>> yeah, but -- well, a fetus. i refer to the fit as a baby. that's notot true for the baby,s it? >> the evidence that i presented to you, senator kennedy, was evidence about measurable effects on the lives of women -- >> right. i got that point, but that's not true of the baby, is it? >> i don't -- i'm sorry, i don't really understand -- >> let me put it -- >> let me back up. as an economist, i measure effects using data. i'm not here to talk about ethics, assignment of perso hood. th not my -- you agreed with the chairman's statement that reproductive justice is economic justice. there is no economic justice for the baby. because. the baby's dead, right? >> i wouldn't refer -- i don't really know how to answer your question. i would -- >> was the baby dead or alive? >> we're referring to a fetus. >> okay. is the fetus dead or alive? if after an abortion?

>> the fetus would be dead after an abortion. >> okay, all right. if the mothers healthy and the baby, is healthy, do you suppot abortion up to the moment of birth? >> so is i, you know, i think that's, that's a really hard question to answer because that just doesn'tus happen. you're asking meki about somethg that simply doesn't happen. i will tell you finish. >> well, it's legal, it's legal in vermont, new jersey, oregon, colorado, new mexico, alaska and the district of columbia. and the -- wing of the democratic party supports abortion up to the oklahoma of birth. so do you support that or oppose it in. >> i don'ts: think -- it? >> i don't think -- let me say i'm here to talk about the economics of abortion, and i think you're asking a question as a person which i'll answer as a person -- >> okay, you tell me as a person. >> i a will tell you as a persoi

have ambivalence about abortion. i will tell you as a person i haven't personally had an abortion, and i will also tell you as a person looking at the evidence around me and understanding how complex the hdecisions are that people face -- >> okay. >> -- i'm just simply uncomfortable -- >> aye got to move on -- [inaudible] if. [inaudible conversations] >> i trust women and their healthi care providers. >> it's real simple, you either support if abortion for a healthy mother and baby up to theo moment of birth or you don't. and i don't think it's a difficult question. how aboutut you, doctor? do you support if the mother is healthy9 and the baby's healthy, do you support abortion up to the moment of birth? >> so, senator, you're using really inflammatory language to talk about a medical procedure, and it's not a simple yes or no. not to mention if when you make statements like that, you're erasing therauma --

>> right. you're not going to answer my question either, are you? >> it' be answered in an appropriate way. >> i i think i know your answer. mrs. if ford -- mrs. ford, okay, let's take a baby at 21 beaks. -- weeks. this is a baby at 21 weeks, o.k. the baby can feel pain, right? >> yes. >> and the baby's pretty developed, right if. >> yes. >> and do you know the name of the period your that the doctor would -- procedure that the doctor would use to abort that a baby at 21 weeks? >> i'm not a doctor, but i think it's a d and r. >> a dilation and pressure -- [inaudible] right? first, the doctor would dilate the cervix, and then the doctor

would call it a sulfur clamp, it's really a pair of pliers with sharp teeth on the end. and without giving the baby any pain if medication, the doctor would go through the vagina, through the uterus and start tearing the baby apart, is that right? >> as far as i understand -- >> yeah. long --pand then she might go fr

protecting mothers and killing babies. >> i'm going ton to senator stabenow -- >> i'm sorry you don't want about to hear it -- [inaudible conversations] >> my apologies. [inaudible]t's ugly, but it's -- >> mrs. fill lips, i'm so sorry you just had to hear that, particularly ass you're talking about the one-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 anyother woman who has to

make decisions based on their life and what's happening in their pregnancy. and so thank you so much for being here. this is about the freedom to makeo decisions, health care decisions, for women. half the population. freedom to make our own health care decisions. in michigan after roe v wade was overturned, women, people across michigan put this on the ballot for our michigan constitution in 2022. overwhelmingly, democrats, republicans, people of all ages voted to put that in michigan's constitution, the freedom to make ourto own reproductive heah care decisions. and which is great except now we hear with a national abortion ban being talked about by our republican colleagues and if we have a republican president, a national abortion ban takes that

all away way. and we also know that ivf now, which is the choice to have a baby and go through ivf, that also potentially isei taken away. and probably birth with control'str next. so this is about basic freedom. and so i just want to start a little differently than i had planned. but, ms. call, you talked about no woman should feel artgree mo. i work on nutrition the issues, health care issue, i've been at the forefront of all of these issues. i could not agree more.tening t' story today -- fill lips -- phillips, do you think she had another option? >> thank you for the question, senator stabenow. so i am not a medical doctor, bd 4,000 babies and has as cared for multiple women who were in a similar situation to mrs. phillips, and i knowork-

>> [inaudible] in the interest of time, i didn't mean to interrupt you, but you're saying her baby was dead. >> right. another option. >> well, when her baby is dead, it's no longer an abortion. at that point it's an a d and y -- d and c, i believe with, medically. >> okay, thankab you. i appreciate yourr work, but again, there's a lot of different stories to tell here. also i wanted to ask mrs. fored, you talked about the -- mrs. ford, you talked about the safety net. right now we have a situation where we need, we're working to fully fund wic for pregnant moms and babies, healthy food, nutrition, so on. do you support wic as a -- >> yeah. >> -- funding work ic? >> wic is an important resource to mothers, especially providing formula to their children. >> so we shouldn't have waiting lists, which is going to happen if we don't fully fund wic. seems to me if there's a 9-month

pregnancy, you can't have a waiting list. you mentioned wic as being a support and that's something that you'd's support? >> yes. >> we also, i've been trying years, actually, senator grassley and i for years to put in place quality standards for labor and delivery under medicaid. half ourabies are born with medicaid health care, and republican colleagues have stopped that here in the senate for years. finish we don't have quality, national quality standards. i assume as part of the safety net, mrs. ford, you would support having quality standards for labor and delivery? y>> yes. across labor and delivery and especiallyly post-abortion care. -- [inaudible] board of outcomes, and most abortion clinics actually, women who are experiencing trouble are normally referred to a hospital e.r -- >> i'm talking just healthy babies. >> yes. across -- >> we should have that. >> [inaudible] >> and colleagues should be working together to do that. >> yes. >> yes, we should -- and i assume, mrs. call, you would

support having quality standards as well. >> yes, i agree. >> okay. which is not happening because of folks here in this body. so, mrs. phillips, let me go back to you with. , again -- thank you, again. how has this horrible experience that you had to go through changed the way you think about your family's future and the kind of world you want your daughter to grow up in? >> thank you for that question, senator. it has been extremely difficult. as i stated before, this was a planned and wanted pregnancy. we still want to expand our family. that's something we plan to do. but, unfortunately, while the ban still sits in tennessee, we're terrified. it was a very traumatic experience that i had to go through, that my famil through. my card here says mom and activist. since what happened to me have turned to activism because my daughter is

growing up in a state without e bodily autonomy. my daughter is growing up in a state that lawmakers are telling her that she doesn't have a choice. it's one thing to put me through it, i'm a 29-year-old woman, but .to put a child through manager like that is -- that is inexcusable. and i would say that i'm hopeful that we can come to an agreement, a nonpartisan agreement, in our state capitol and restore abortion access so i can continue my if plans of my future and expanding mily, because that's something i desperately want to do but i'm terrified to do. >> thankri you. american women deserve the freedom to make their own decisions and, mr. chairman, this side of the dais trusts women. >> senator lee. >> thank you, mr. chairman. >> sorry to interrupt. followed by senator americaly. >> at the outset, i feel i need to point out something that i think the casual observer might

miss from some the comments. the dobbs decision did not criminalize abortion. the dobbs decision didn't do anything to affect the legal stus l of abortion other than to return the decision, the primary decision on abortion, back to the states. always been an issue that was before the states prior to roe verse wade and its progeny. dobbs simply undid roe and said this is a decision that most of the s time as we'reea the district f columbia at a military installation are, using government funds or something like that, isn't normally going to be federal action. and so they returned it back to where it was. now, states have been more or less out of this arena for about 50 years. they had been out of the arena for about 50 years as most abortions occurring in america couldn't be meaningfully

restricted in light of roe v. wade and its progeny. states are getting back to that business now after it had been usurped by a judicial oligarchy of sorts for nearly half a century. so, yes, states will handle this differently, but states handle many things differently. everything from occupational licensing to what procedures might be performed in certain states, even the criminal laws of one state differ from those of another. those laws are made by men and women elected by the citizens of those states. sometimessean end up having unforeseen consequences, sometimes tragic ones. those laws can be changed from time to time. but it's important to focus on what this is about and what it is the not. it is at the end of the day something that is in the hands of the american people. this is part of what having a democratically elected government means. it's what it focuses on. i've heard several mentions made

to the idea that there's suddenly going to be a national abortion ban, a federal abortion ban enacted. to my knowledge, republicans who now control the house haven't even pushed for a vote on that elsewhere. the same can't be true of the bornrn alive protection act. it's a different circumstance. once a child was born alive, i would hope we could all agree regardless of what your religious, moral or policy feelings ab abortion are, i would hope we could all agree that once a child is born there are all kinds of protections and that allowing unsomeone to be killed carries all kinds of other ramifications. ms. ford, i'd like to start with you. i'd 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 effects on things like family harm, for ex,

married couples with children in a a way that doesn't affect other families. >> yeah. i'd like to start by pointing out that marriage penalties in the safety net would exist primarily in a program explicitly likera thenned income if tax credit. you can earn thousands more if you are unmarried and have children versus if you are married and have children. but there are also implicitly throughout the rest of our if yt declare the partner who you are not married to within the home, you can receive thousands more s s.n.a.p. benefits or tanf benefits. and the effect that we see that this had on our culture is within the unmarried birthrate. we have the highest number, percentage of children living in single parent homes in the world. it is about a quarter of u.s. st homes as compared to 7% around the world. >> are you suggesting we have, thus, incentivized out of■g wedlock birth and child rearing?

>> the information seems to be flowing that way because when we track cdc data, if you're looking at college-educated women, fewer e than 10 or11% have children out% of wedlock. that's roughly similar to what was happening in the96ng at less educated women, it comes close to 60%. it really does hit on education levels and income levels whether a child is going to be born o wm the data that there is an impact to having two parents in the home. this is why most -- [inaudible] the two-parent if privilege was published. she's not right-leaning, this is following the data. there is a huge benefit to having two parents in the home withe the child. >> how does that contribute to perpetuation or even exacerbation of ein inequities along racial, economic and other demographic lines? >> we know that if there is a single mom a single parent

who is raising her child alone, she is much more likely to experience economic hardship, and it is much more likely for her children experience intergenerational poverty. the 60 years that dependent children in ts program that provided cash assistance toer mothers, by the mid 1990s, 9 in 10 women were unemployed, 1 in 7 children were on the program. and after it was reformed to focus on birth, the out of wedlock birthrate stabilized. child poverty in this country dropped bype 60%. >> human beings are rational actors, and when we incentivize the■■j wrong things, we'll get those things. and those things can sometimes harm a lot of people, especially the most vulnerable. thank you, mr. chairman. >> thank you senator lee. the order i have at this stage depending on attendance is senator merkley, senator braun, oraisenator wyden. that's the e sequence, but if

people aren't here, you can be bumped up the sequence. senator merkley. >> thank doctor, if in some the statements i want to -- states, i want to understand if an ultrasound reveals that the fee fuss -- fetus does not have a heartbeat, are in some states would, it be basically law now require that woman to carry that child until there is a miscarriage, that child who does not is havesc a heartbeat? >> so i don't know of any suits -- states that require people to carry pregnancies that are true miscarriages. what i can say is with procedure bans around d can can -- d and cs, it can require a patient to have experienced a miscarriage where the fetus' heart stops beating d

of having a medical procedure that could end their suffering quickly. >> okay. that was exactly the situation we were in with our first child. we lost our first child at four months.. and i think it would have been extremely difficult for mary to be required by the state to carry that, that child post that point. >> i'm sorry. >> i want to turn, professor myers, to poise san -- poison pill riders that the house has proposed including riders that restrict access to medical or medication of abortion. what would be the economic impact of passing an appropriations bill with some of these extreme anti-abortion riders? >> thank you for that question. the economic impac could be tremendous depending on the rider, but i'd really like to talk about medication abortion for just a second that has become incredibly

important to the provision of an abortion if in this country. even before dobbs, more than half of abortions provided were provided as medication abortions. and if right now about 40% of the brick and mortar abortion facilities in this country only provide medication abortion. the remaining facilities with very few exceptions provide both medication a abortions. if the medication access were meaningfully reduced, it would upend the telehealth provision which has become extraordinarily important to people, it could shutter providers, brick and mortar providers including in states that have been supportive of abortion rights and might not understand the threat that faces them. andan it would create really limited appointment availability at myities that remain. ..

thank you for that question. we have seen increasing leak leaguenumber of care we are pro. times increase in care provision in the last year end a half since the dobbs decision. in addition to a 4 procedural abortion care that has been seen it's hard to quantify how much is from out o state more patient÷u■z sitting e care not being able to access it. clark's is that created delays and winds access to reproductive care? >> yes is only a certain number of us who can provide this care given the specialty trading in order to do it. none of us ever went to delight patient from receiving necessary

medical care but so many hours a day will be actually can provide that care progress oregon has certainly seen as supportive as much of the thousand% increase across the state line from idaho. mrs. phillips, thank you for sharing yours, story. the story i can connect with my own family's experience. although not all of the pieces were so because of the restrictive laws in tennessee is that the case your doctor was not even able to offer advice to you on how to obtain an abortion? >> thank you for that question, senator. my doctor taken an oath to provide the most oath of her patients at that point in time the way she understood tennessee's law wished she could not offer me resources.

she stated i would have to do the research on my own i was left to essentially defend myself my own life and fertility. >> thank you very much, thank you, mr.haquicksilver braun foly senator padilla. i'm going to preface it with these comments. colleagues before have had questions about the nature of life and human essence and have made theoi to distill that into economic terms. when you tried to do it, especially through an institution that has now become one that has no problem with them borrowing and spending money from future generations just to tell you where we are out there, this is the budget

committee we are now borrowing $1 trillion every six months. you know who is back that's going to be upon? our kids and our grandkids. that is proba more printed and subject to what we are talking about here today. but, on theou subject matter we have got here that has nooo it d a business plan as anyone would ever want to be a part of. but he to try to speak about this in economic terms i think from the state i am from, this is a question of being profamily, pro- mother, and that would be a place that would be a legitimate place to have a discussion. just not trying to do anything about it if you are for it when you're borrowing it from yr gra. indiana has affected public and

private networks to help women without urging them to an innocent life for the general assembly's fulfillment of indiana's culture of life includes the decision to disperse tnf funds to pregnancy care centers and alternatives to abortion programs on mothers should not feel alienated from roassistance unforced into abortion. sadly the biden administration embraces a culture the opposite. to strip support for pregnant women and their u babies. i just think it is the wrong place toto go. my question is, what you tell 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 maybe talk

about life and preserving it, what is your opinion on that? >> yes. your question is what we tell families about that i guess can you repeat exactly question will be to answer, sorry for. >> when you have young families with these issues, what is your advice as opposked to at the been pushing to take funds, borrowed money to facilitate ending life. what should be the message? >> i believe the message should be there areer people here who e very ready and willing to support you. this state is ready and willing to support you turn our local community is ready and willing to support you i'm very thankful in the state of iowa they recently passed the moms program which provides state funding to centers like ours so we can truly support these women where they are. i want to be very clear we never

suggest to a woman what she should or should not simply give her thehe informati. let her know all of the resources that are available to her it can be tricky to all of these systems and institutions. and so we are just there to be an advocate for her and to help her walk that. >> have you had any outreach from the biden administration to help you in your programs? >> no x0? >> zero. >> at something if you are going to try to push one dynamic at least to be fair it out to be something you're willing to the other point of view as well, thank you. >> thank you. i want to lead with a couple of

data points first i want to thank you all for your testimony and your participation today it is important and timely conversation obviously. about 42% of adults up from 33% just about five years ago say they have either used fertility treatments or personally know someone who has.imated at 1.5 million frozen embryos the recent ruling in alabama effectively bans ivf in certain states because it would subject the people involved in all steps to unreasonable criminal liability. as republicans continue to stumble over the arguments against reproductive rights, what i see happening is they are realizing it is one thing to say you are opposed to abortion in

theory. it's a whole another thing to try to legislat> thank you for that question senator. if i am understanding your question i think the hardest part about all of this discussion is reproductiv st when to have a family and when not to and the safety around how

you choose to parent your children as well.d the argumentn conjunction with the argument about why abortion care is necessary me healthcare you are taking away the autonomy of families to make the decisions that are best for them. and you are erasing grief and trauma for those families that are having to make decisions at a very difficult. having known plentyeagues as wes have had to go and fertility treatments that's a very difficult road for them. then to have their time and energy responsibility taken from them by the state told what they can and cannot do without is just as scary as what we are seeing with patients coming to us for abortion care. >> i appreciate the perspective as a physician in this. because for a party who claims to be about rights and freedoms

and liberties they are taking away rights and freedoms and liberties from families across the country. doctor myers can you talk more about the societal and economic impacts of banning ivf? >> yes i will preface it by saying this is a bit of a mixture of personal and professional. my child as a product this hits close to home for me what's happening into alabama. reproductive autonomy is not just about young people avoiding parenthood until they are ready. it's about all people being able to become parents when they want too. ivf has helped millions of people, including me with the economicts evidence suggests tht it allows women to spend more ti seeking the right partner. investing in education and investing in their careers.in

in a country and a moment we are increasingly seeing people delay parenthood date lack of access to ivf is very concerning term the perspective. >> thank you very much and if i can in my brief time are many i do want to touch on another topic. i think exemplifies across the country there are obstetricians, gynecologist, nurses that are leaving their practices in states like idaho, texas, oklahoma and tennessee while new doctors are voidi those states altogether. taken the departure of respected and talenteded physicians many hospitals have since closed their labor and delivery units in these red states. so the brain drain extends beyond maternity care while in the dobbs decision a growinge ud their health insurance policy to include abortion travel

benefits. it is because impact state laws restricting abortion care have on their ability to attract and retain talent. dr. kag you left it tennessee as you shared your testimony as a result of dobbs in the states abortion restrictions i can imagine republican attacks is driving obstetricians and other healthcare professionals from red states h does this impact access to the central healthcare services including prenatal visits? including access to contraception. fetalding maternal medicine and postpartum care and more in those states and being left behind? >> thank you so much for that question senator. i have a deep concern for what can happen in these continue being taken away. we know even prior to dobbs it

states that had abortion care restrictions had worsening morbidity that was still divided and worsened across racial lines as well but now were adding in the fact physicians are afraid to be in seats where there are significant abortion bands you are eliminating an entire and in addition almost 50% the ob/gyn residents are training in states with his abortion care nl graduate an entire generation ob/gyn who do not know how to do dnc for miscarriage management who are not equipped to counsel patients appropriately about the findings of their pregnancies. who are not going to be able to provide necessary emergency metal in these communities i am very afraid with that's going to mean for their patients. multiple maternity wards closed over the last several years is

almost 25% of the ob/gyn workforce and there's maybe two maternal fetal medicine positions left in the entire states. patients are traveling 200 miles an estate had terrible maternal mortality and morbidity i worry what tha means f the states andw we are going to continue to watch women die. >> and her cane.ously we have ds policymakers we are seeing what impact it has had on medical professionals. in states across the country but the ultimate consequence this is why you're having this hearing, the ultimate consequence is on women and families that needs to be at the center of our actions here, thank you for quick senator kaine and then senator van holland and the senator returns for. >> thankca you. ms. phillips your customers

incredibly powerful i really want to thank you for sharing it. the legal system of tennessee and this country has really failed you as listening earliers to beat non- judge mental into what they choose to do print your state does not let you do that. physicians with the fact you have a physician has taken an oath to provide youth patient care is so afrd of criminal liability of loss of licensing privileges that when you are given this devastating news you and your mom have to go online and search to find a place thousands of miles from where you live far away from any family in the city you have never visited if i remember your testimony right. to terminate of failing failed pregnancy. the cruelty is astounding. astounding. i wouldustpz like to go back and click that piece of thece testimony we want to accompany

women and let them decide what is in their best that is what a healthcare provider testifies, why wouldn't a statewide legislature or a court or congress have that same attitude? i want to push back a little bit on senator braun's notion he was pushing a line the biden administration is interested in abortion and not on moms. let me correct that. the american rescue plan was the first piece of legislation that was passed under the biden administration and they want her 17th congress my colleagues and i were here passed by one vote. one vote. every democrat voted for it. every republican voted against it. american rescue plann really important provision for moms andea kids. prior to medicaid would cover a amom after delivery for 90 day. more than half of the births in this country are medicaid

births. prior to the american rescue plan a mom's w for 90 t days. in the american rescue plan we allowed states to expand that 90 days to one year where the mom gets covered for a year because there are so many challenges mothers face postdelivery. that passed by a one votes, democrats is thate, joe biden ad harris said that every republican voted against inmothers. they voted against mothers and that mandate?ates have done■- w we extended it and an appropriation bill the next year 45 statesave decided to embrace the optional mandate we allowed them to do. embracingo the biden policy embracing a policy of the demoats supported every last republican in the senate opposed. i imagine you been here longer than me, there are days when you are here and wonder for doingans when there are things by one vote. american rescue plan, moms get medicaid coverage we saved

2 million pensions. saving the affordable care actct in august of 2017 happened by one vote the inflation reduction act tori prescription drugs happened byow one votes. american rescue plan had another the tax credit reduced infant poverty by 45% within six months passed by one vote. every democrat supported it. every republican opposed it. i gather from your testimony professor myers one of the reasons women often cite for terminating a pregnancy is financial pressure. the financial pressure of healnancial pressures of raising kids and finding childcare. knowing you are going to be covered for health care in the year after delivery. knowing you tax credit to help you with the reexpenses, these are the kind f policies that are pro mom and

pro family might even help the u.s. deal with the declining birthrate and turn it around. we could start of a growing birthrate of families felt they had a financial cushion in the financial pressure was not causing them to consider terminating a pregnancy. in my right aboutg that? >> yes, i think y thank you for the question. american birth rates have been plummeting the reasons a very complex but i think we should all be very concerned about that through multiple lenses including a fiscal lens. one of the reasons people for delaying,ar becoming parents are having fewer children is financial concern. i agree with mrs. ford we could bolster the social safety net. we could reduce a marriage of penalties i think that's a really good idea but you just cannot leave out the other financial concerns t that affect families in the child tax credit was an incredibly important

piece of the social safety net expanding medicaid is an important peacemaking welfare benefits more accessible, doing things like reducing child cap's limits there a need to do to bor the social safety net and in doing so we would likely help work against us concerning the e trend of declining births. >> thank you yelled back mr. chair for quick senator van holland. >> thank you, mr. chairman thank all of you for your testimony i would not in the room i saw your testimony on c-span is the hearing progress. sharing your very personal story. does miley rosa great speaking f other americans. so now you have experienced a senate hearing. lots of things evan said. i want to give you the opportunity as we close it may be the last sat

questions. after you have heard everything here today, is there anything you would like to say in response make sure we can correct any mis- perception some people have expressed. >> yes and thank you so much senator for giving me this opportunity. i will start by saying that i made a pmi her name would not die with her. that is a part of why my activism iss so important to me is so that people know who shet is. i want to make two statements before i go into my final thing i like the committee to know i think of senator kennedy came to this hearing knowing there's going to be a mother here who had to make the difficult decision to terminate 20 week legacy he decided best interest his testimony was nothing but fear mongering for from my experience that was not my experience.

what he was trying t also mrs. kaul, to answer your question to what he had asked, my procedure was in abortion it's on my medical paperwork i had an abortion even though my daughter was deceased. it is notforth. in abortion is a medical procedure. i would like to ask the committee to remember my■- stor. remember i am one of thousands of not millions of people in this country that need or needed abortion access remember is not black-and-white and one size does not fit all. wewe cannot be putting politics and health care decisions for it and also a member the fact abortion access isssential healthcare noo matter how you want to look at it. it is essential healthcare for sot many. exceptions don't work. i am a living had a very vague exception to protect life of the mother prints might life was at risk and i did not qualify. i would ask the committee to

consider passing a law that allows access without exception all across the board. because when someone needs healthcare they should be able to recei that healthcare when they needed and not have to navigate the hurdles like i did. because, like i said i don't if i madet be here with you today i'm very thankful through the opportunity is given to get to new york and now this opportunity to fight extreme bands we are facing in many states. >> i think it ms. phillips. thank you for your earlier testimony powerful closing. dr. kagan if i could just ask you to elaborate a little mor cs to face in trying to navigate these legal areas. that asked question some the questions i plan to act on doorffed

and other states. how that leaves women in the workforce in states like tennessee at greater risk but it is because doctors do not want to end up being fined or worse for their actions. and i know from your testimony you call upon your fellow physicians when you were in tennessee and others to try to navigate these things. how it is an impossible standard. can you justnd of experience ofo go through these difficult decisions when people are talking and imposing legal penalties? >> yes, thank you so much for that question senator. i am a physician and not a lawyer i did 11 years of training in order to become■s a

doctoror and then allow went ino effect that took of my ability to care for my way that was necessary, a way for me and from so many others i will never forget the days after jobs the number of conversations i had with our hospital lawyers, my criminal defense attorney, the lawyers across the country who were trying to navigate ever-changing experience for patients and providers. i was not able to care for patients i was trying to figure out if i could even take care oe ask if he could give chemotherapy to a breast cancer patient who just found out was pregnant he was worried if she did and miscarried he would go to jail. for taking care of his patients. it is still terrified we navigate this on a regular basis with patients coming to us with very complex care trying to make sure they have all the follow-up and care they need back home

while still protecting their privacy. it is untenabed i have to leavea place i loved that a community i care deeply for. but i knew i could not do any good if i can practice medicine anymore. >> thank you doctor. thank you, mr. chairman. >> thank you very much we thank all the witnesses. there was a comment, a critique professor myers of your the caul effect between b reproductive ce restrictions and the economy. specifically the appropriate conclusions to be drawn fromhe turn awayn study, you have not had a chance to respond to that of think ino fairness i should give you a chance to respond to that if you would care to be. >> think interment white house are like to return to that. i want to say first of all very clearly most of the evidence i

present andnd shared my testimoy is not from the turn away study. there is ample evidence for multiple independent rea experiments to isolate and measure the abortion of abortion and access we are not just talk about the turn away study by any about the turn away study that evidence is causal and to illustrate one of the most important studies to come out of to be clear it's not mine it's anotherch team, it took people o were in the turn away send their seeking abortion, arriving at providers summer finding out they were just past the gestational age limit to receive the abortion they wanted and they were turned away. under itd receive that abortion. >> was the name of the study. the researchersonir experience and they followed what theirpo credit reports it looks like four months, years before the pivol event in their lives the

two groups are trended incredibly similarly they look really, really similar up until the moment this happens to thern incredible divergence and all the sudden people who are turned away have this enormous increase in adverse credit. reasonable person can look at that evidence and say that is just a correlation something else happened that day that cause their credit to fall for. >> and rick, thank you for that response. thank you all for your testimony here today.(o i note mrs. phillips this is particular difficult for you and some of our colleagues made even more difficult and i apologize for that. i thank you very much for b here for the record will remain open in case intimate wishes to add anything for another week. and without this hearing is concluded. [background noises]

[background noises] >> all we we've been featuring state of the state addresses from acrs the country. from coast to coast we beaches by governors offer a wide range of persptis highliting priorities and challenges faced by different regions of the hr from the governors o new york, florida, pennsylvania, indiana, iowa, and arizona.

♪ c-span is your unfiltered view of government. funded by these television companies and more includingcox. >> is extremely rare. but friends don't have to be. when you are connected, you are not alone. x giving you a front receipt to democracy. [applause] clicks democrat kathy hoag was been governor of new york since 2021 filing the resignation of then governor andrew cuomo. sh previously served as lieutenant governor in the five and a half years and prior pay for her state of the state address back in january and she highlighted public safety, homelessness, hate crime prevention, and business investment among other topics this is just over an hour. >> pursuant to a res