On this 44th anniversary of Roe v. Wade, Sociologist Gretchen Sisson of University of California, San Francisco talks about her research into abortion-related plots on television.

MICHEL MARTIN, HOST:

Today is the 44th anniversary of Roe v. Wade. That’s the Supreme Court decision that effectively legalized abortion in the United States. Hundreds of thousands of people gathered in cities across the country yesterday to demonstrate. And part of what brought many of them there judging from their signs and social media posts and interviews clearly was their concern that access to abortion will be restricted. Meanwhile, this Friday, people who favor those restrictions on abortion will rally at the National Mall in D.C. and march to the Supreme Court in what has become an annual event, the March for Life where President Trump senior counselor Kellyanne Conway is expected to speak.

Now, the truth is most people don’t go to rallies or marches on either side, but there’s evidence that the long controversy about abortion rights is playing out in a different public square, a place most Americans visit. And that is primetime television. Gretchen Sisson is a sociologist at the University of California, San Francisco, who researches how abortion is portrayed on screen. And she’s with us now. Welcome. Thanks so much for joining us.

GRETCHEN SISSON: Thanks for having me, Michel.

MARTIN: Now, a lot of people will remember the TV show “Maude.” I understand that that was actually not the first TV show that portrayed a character as having an abortion. But it was the first that portrayed the decision in depth and in primetime. How big of an impact did that make? How big was the controversy around that?

SISSON: So the controversy was pretty big at the time, and it’s important to remember that the show is set in New York. Abortion was legal in New York before Roe, and that episode aired in that window where it wasn’t even legal and accessible yet nationally. “Maude” was, of course, a little bit older for a pregnant woman. And it’s actually Maude’s daughter that is very encouraging of her mother’s abortion and says this used to be a very shameful thing, but it’s legal now. It’s just like going to the dentist. For the time when it aired, it was pretty radical.

MARTIN: Now, in 2015 and 2016, HBO’s “Girls,” “Scandal” on ABC and “Jane The Virgin” on CW all portrayed characters having abortions, so clearly it’s become more commonplace as a storyline. Do these storylines still evoke that kind of controversy that “Maude” did back in the ’70s?

SISSON: So I think we’re starting to see a shift. If you had asked me this question two years ago, I would’ve said that the stories were actually pretty reminiscent of “Maude’s” episode where a lot of the story is really focused on the decision-making process and how emotional and difficult that was for women.

It’s become much more a matter of fact, and the stories are less about the hardship of making a decision around an abortion and more about what this potential pregnancy and what the abortion means for the woman’s relationships, what it means for her career.

MARTIN: One point that you made in your research you – says that typically on television an abortion is had by a young, wealthy, white woman who has no other children. Is that the way it is in real life?

SISSON: No. It’s certainly not the way it is in real life. That experience isn’t inaccurate. For many women, that’s their reality. But we know a couple of things. Most women in the U.S. who get abortions are women of color. Most women who get abortions in the U.S. are already parenting and raising children. And until very recently, I would say their stories were largely undepicted (ph) on television.

MARTIN: Would people who believe that abortion is a profound moral dilemma – would they find depictions of that on screen today?

SISSON: I think we are seeing that balance, but in different ways than we used to. So, for example, on “Jane The Virgin,” Xio’s abortion is handled very straight-forwardly. We find out about it after the fact. And then the story is less about her decision to get the abortion and more about her disclosing that abortion to her mother who she believes will be opposed. So they sort of have that conversation in a different space.

MARTIN: If people watch television, whichever side they’re on, are they likely to see their reality, their point of view reflected in what they see on television?

SISSON: I think the stories we’re starting to see on television are becoming more diverse and thus more accurate. I also think that if you are in favor of abortion rights and you’re looking ahead to the next four years and feeling like little policy progress is going to be made in support of abortion access, then the cultural sphere including television offers something more to move forward with, to change the way people are thinking and talking about abortion in those spaces.

MARTIN: Gretchen Sisson is a research sociologist at the think tank Advancing New Standards in Reproductive Health or ANSRH at the University of California, San Francisco. We reached her in San Francisco. Professor Sisson, thank you so much for speaking with us.

SISSON: Thank you.

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NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Donald Trump was president for less than a day when he signed an executive order guiding agencies to limit the way that the Affordable Care Act works. But does the executive order do?

MICHEL MARTIN, HOST:

We’re going to take a break from covering the women’s marches today to talk about one of President Donald Trump’s first moves after taking the oath of office yesterday. President Trump signed an executive order to limit what he calls the quote, unquote, “burdens of the Affordable Care Act,” taking a step toward fulfilling his campaign promise to dismantle the law. NPR health policy correspondent Alison Kodjak is with us now to explain exactly what Donald Trump’s order does and what it cannot do. Alison, thanks so much for joining us.

ALISON KODJAK, BYLINE: Thanks for having me.

MARTIN: So what exactly is in this executive order? What is the president trying to do here?

KODJAK: Well, the order talks broadly about, quote, “easing the burden of the Affordable Care Act.” But he talks about easing the burden, not just on individuals, but on insurance companies, on hospitals, on doctors, on medical device-makers, pretty much across the board, saying this law is hurting the entire health care industry.

And what it does is essentially sets the direction of policy for it. It tells all the heads of all his agencies, who haven’t yet been confirmed mostly, that they should find ways to ease the financial burden of this law on all these constituencies.

MARTIN: Now, that’s a pretty sweeping mandate. What can the order specifically require them to do at this point?

KODJAK: Well, it’s a little bit vague because it depends on how aggressive they want to be. He specifically mentions the Department of Health and Human Services. He’s nominated Representative Tom Price, who probably will be confirmed sometime in the next days or weeks. The HHS has a lot of regulations, such as the minimum requirements for coverage that they could change through a rule-making process. In addition, the HHS has the power to offer waivers to people who say that the individual mandate to buy insurance is a hardship.

So there are some people who speculate, oh, they’re going to just start giving waivers to anybody who complains. They can’t not enforce the law, meaning they have to have the IRS actually collect the penalty if people don’t buy insurance. But if they offer too many of these waivers, that could kind of undermine the individual market by making people not buy insurance.

MARTIN: But is the danger here that the individual market could actually collapse before there is a replacement for it? Because that’s what leads me to – my final question to you is how does this dovetail with President Trump’s other plans and promises?

KODJAK: If they want to have a replacement before they repeal the law, then they clearly don’t want the market to collapse, you know, in some sort of chaotic way. At which point, it’s probably unlikely that they’ll be too aggressive. It sort of just sets the tone of this is our intention, this is what we want to do. However, if they do want to really push it hard, they could do some damage early on.

MARTIN: So Alison, what is the bottom line here?

KODJAK: Well, no one’s quite sure because President Trump and his colleagues on Capitol Hill don’t yet seem to be on the same page about what they want. He has said he wants insurance for all. They’ve said they want to provide an atmosphere where everybody has access to insurance. And so we need to see where they’re going to go with that.

MARTIN: That’s NPR health policy correspondent Alison Kodjak here in our studios in Washington, D.C. Alison, thank you so much.

KODJAK: Thanks, Michel.

Copyright © 2017 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

The Senate health committee heard from Rep. Tom Price Wednesday on his nomination to become the secretary of Health and Human Services. Obamacare was a top issue, and the congressman’s stock dealings in medical companies were also discussed.

KELLY MCEVERS, HOST:

Several of Donald Trump’s Cabinet picks were at Senate hearings on Capitol Hill today. Trump’s choice to lead the Department of Health and Human Services got some tough questions. Georgia Congressman Tom Price was asked to explain why he invested in companies then introduced legislation that affected those companies. Price said he had hired a broker to manage his finances, and he wasn’t aware of the transactions. Price also got plenty of questions about the future of Obamacare. NPR’s Allison Kojak reports.

ALISON KODJAK, BYLINE: The senators tried to pin Price down on the incoming Trump administration’s plan to replace the Affordable Care Act. He had to answer for his own past proposals and for the statements of his future boss. Democratic Senator Patty Murray criticized him for supporting a bill that will allow lawmakers to repeal Obamacare.

(SOUNDBITE OF ARCHIVED RECORDING)

PATTY MURRAY: Just last week, you voted to begin the process of ripping apart our health care system without any plan to replace it despite independent studies showing that nearly 30 million people would lose health care coverage.

KODJAK: But she wasn’t alone in her concern. Her Republican counterpart, Lamar Alexander, made the case for lawmakers to slow down.

(SOUNDBITE OF ARCHIVED RECORDING)

LAMAR ALEXANDER: The president-elect has said, let’s do a repeal and replace simultaneously. To me, that must mean that any repeal of parts of Obamacare wouldn’t take effect until after some concrete, practical alternative were in place for Americans to choose.

KODJAK: Price agreed and suggested Democrats are scaring the public by saying millions of people are about to lose their health insurance.

(SOUNDBITE OF ARCHIVED RECORDING)

TOM PRICE: Nobody’s interested in pulling a rug out from under anybody. We believe that it’s absolutely imperative that individuals that have health coverage be able to keep health coverage.

KODJAK: Price also assured the senators that he doesn’t intend to include any changes to Medicare in the effort to repeal and replace Obamacare. Senator Bernie Sanders also sought reassurance about Medicare as well as Medicaid and Social Security. He read a series of comments that President-elect Trump has made over the last two years promising not to cut any of those programs. Price said he expects Trump will keep those promises.

(SOUNDBITE OF ARCHIVED RECORDING)

BERNIE SANDERS: So you are telling us that to the best of your knowledge, Mr. Trump will not cut Social Security, Medicare and Medicaid.

PRICE: As I say, I have no reason to believe that that position has changed.

KODJAK: Price will face another round of questions next week at his official confirmation hearing before the Senate Finance Committee. Alison Kodjak, NPR News, Washington.

(SOUNDBITE OF CLAP YOUR HANDS SAY YEAH SONG, “THE SKIN OF MY YELLOW COUNTRY TEETH”)

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NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

NPR and the polling firm IPSOS have a new poll out that suggests the public might not be as enthusiastic about repealing Obamacare as their representatives are.

MICHEL MARTIN, HOST:

We’re going to hone in on health care for a few more minutes. As we said, Republicans in Congress have taken some initial steps toward repealing the Affordable Care Act. But NPR and the polling firm Ipsos have a new poll out that suggests that the public might not be as enthusiastic as many lawmakers are about an all-out repeal, at least not without something to take its place. The poll also offers interesting insights about what the public does and does not know about the Affordable Healthcare Act.

NPR’s health correspondent, Alison Kodjak, is here to tell us more about all of this. Alison, thanks so much for joining us.

ALISON KODJAK, BYLINE: Thanks for having me, Michel.

MARTIN: First, Alison, tell us some of the significant findings of this poll.

KODJAK: So the poll showed what I think a lot of people know, which is that the public is largely split on Obamacare. They’re – about 45 percent of people hate it and 44 percent say they like it. But within that split there are some interesting results, which is those people who say they want the law repealed, more than half of them want to see it replaced. They don’t just want it to go away. So in terms of people who want some sort of health care structures to remain in place, that’s the vast majority of people in the country now.

MARTIN: There were some surprising findings, too, at least surprising given the public debate that’s taken place over the last year and over the course of this election. Tell us a little bit more about that.

KODJAK: In the context of this sort of everybody seeming to want to repeal this law, more than half of the people in the poll say that the Affordable Care Act has done more good than harm. So people have a positive, you know, view of what this law has done. And – this was interesting to me – 55 percent of the people we polled said they would prefer to see a single-payer health system in this country. You know, that – it did break down on party lines. Seventy percent of those were Democrats. But among independents, 55 percent wanted to see single-payer.

MARTIN: Tell us about what people did and did not know, given how important this policy has been to the Obama administration. One thing that stood out for me is that a majority of those surveyed did know that the Affordable Care Act protects people with pre-existing conditions from being refused coverage and that it requires insurance companies to pay for preventive care, but there was something that they didn’t know.

KODJAK: What they don’t know is that the Affordable Care Act has extended insurance to millions of millions of people, that the uninsured rate has dropped dramatically since the law passed. And that just seems like the one fact the Obama administration should be getting out there. And people aren’t really hearing it.

MARTIN: So as we said, the Republicans in Congress are setting in motion a framework for repealing the Affordable Care Act. Are we seeing any signs that lawmakers are responding to this new information?

KODJAK: It seems they are. And, you know, here’s what I have seen. Immediately after the election, when Republicans realized they were going to have the ability to repeal the Affordable Care Act, their plan was to repeal the law immediately when they come back to Washington and replace it some time down the line.

And what we’re hearing now since Congress came into session in January – and we’re hearing it from President-elect Donald Trump – is we’re going to repeal it and replace it simultaneously. So even though they’re on their way to repealing it, there’s a sense that they’re going to potentially slow that down while they come up with this replacement plan that they haven’t actually showed the public up till now.

MARTIN: That’s NPR health correspondent Alison Kodjak. Alison, thanks so much.

KODJAK: Thanks for having me.

Copyright © 2017 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Scott Simon speaks with Maggie Elehwany of the National Rural Health Association about a possible Obamacare repeal. She supports the law, but says the way it was implemented has hurt rural hospitals.

SCOTT SIMON, HOST:

The House and Senate have taken the first steps to dismantle the Affordable Care Act. It’s not clear whether lawmakers will have a replacement for the law before it’s repealed. The Affordable Care Act has allowed millions of Americans to buy health insurance for the first time. But it has been controversial. We don’t know the impact on hospitals. We’re joined now by Maggie Elehwany. She’s a lobbyist with the National Rural Health Association. They represent nearly 2,000 hospitals in rural America. Thanks for joining us.

MAGGIE ELEHWANY: Thank you.

SIMON: Recognizing that there’s no one answer, how has the Affordable Care Act affected rural hospitals?

ELEHWANY: Well, let’s talk about kind of the overview. So the goal of the ACA was to help the 37 million uninsured out there. And, yes, uninsurance rates have gone down dramatically or at historic lows. But I think a lot of things were unforeseen.

And the way some of the regulations were implemented are actually harming rural America and not fulfilling the ultimate goals of the ACA. And what I mean by that is half of those 37 million – the goal was to expand Medicaid and get those folks into a Medicaid program. We know that a lot of states have taken the Supreme Court up on its option of opting out of Medicaid. That has predominantly hurt rural America.

In fact, if you’re a rural state, if you’re a poor state, more likely than not, you have not expanded Medicaid. So we’re seeing millions of folks left behind at that. Our concern is that since the ACA was passed, we’ve had an escalation of rural hospitals close. We’ve had 80 rural hospitals close since 2010. If this rate continues, in less than 10 years’ time, we’re going to have 25 percent of rural hospitals close within less than a decade.

SIMON: Do you have any concern about the Congress repealing the Affordable Care Act – what’s called Obamacare – without a replacement?

ELEHWANY: We certainly do. I do not want to take away, by any means, the good that it has done in rural America. I said it’s brought uninsured rates down by 8 percent. It’s allowed families to keep their children on their plan until they’re age 26. It’s helped people buy insurance if they’ve had preexisting conditions.

We do not want to see rural Americans lose one lapse in the benefits that they have. We are not mad at Republicans or Democrats. We’re mad at Republicans and Democrats. We want to make sure that they understand that the well intentions of the ACA have really fallen short and may actually be exacerbating the hospital-closure crisis.

SIMON: We’ve done a little reporting. I’ve done some stories in rural hospitals and health care over the years. It can be hard to get doctors to some locations, can’t it?

ELEHWANY: Yes, absolutely.

SIMON: Because they spend a long time in medical school. And there just aren’t necessarily the opportunities for economic success in a rural environment that they would have in a big city.

ELEHWANY: That’s absolutely true. Recruitment and retention of physicians remains one of the top problems in rural-health-care delivery. And I talked about – to bring it back to the Affordable Care Act, there was some other positive provisions in the Affordable Care Act that, sadly, were never funded by Congress through the appropriations process that we think really could’ve helped recruitment and retention of physicians. There were some specific programs targeted to help workforce issues in rural America. We would love to see, when we address building upon the ACA, reforming it, those programs.

SIMON: What do you hope Congress does?

ELEHWANY: I’m not speaking in one political aisle or the other.

SIMON: Yeah.

ELEHWANY: But rural America spoke very loudly. On a 3-to-1 basis, they voted for Donald Trump. They were voting for a concept. I believe that they feel that they have been left behind. And if you think about it, it’s not just health care, where they see their hospitals closing. And one hospital CEO described it as a three-pronged stool. It’s the churches, the hospitals and the schools. If you lose one of those legs of that stool, the whole community collapses.

So these towns with their hospital closing are seeing elements of their community go away. Their physicians may leave ’cause they’re hospital-based. The nurses leave. The pharmacists leave. These medical deserts are forming. You know, there’s studies that show even housing values drop after a hospital closes. So what business wants to relocate to these communities?

There’s just not the vitality, the job growth in rural communities. And I think there’s a lot of frustration out there that these are hardworking folks who sometimes feel that, inside the beltway, the people in Washington D.C. have forgotten about them.

SIMON: Maggie Elehwany is vice president of government affairs and policy and chief lobbyist for the National Rural Health Association. You represent rural hospitals. Thanks very much for being with us.

ELEHWANY: Thank you so much.

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NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Tennessee has one of the least healthy populations in the country, a problem its Republican governor tried to address by expanding Medicaid. It was rejected, and insurers have raised their rates.

ROBERT SIEGEL, HOST:

Republican voters have been vocal. They want to see the Affordable Care Act repealed. Well, now that it appears to be happening, some of those voters have a different message to Congress – delay. Chas Sisk of member station WPLN in Nashville explains why many people in Tennessee want to go slow.

CHAS SISK, BYLINE: It seemed like a risk worth taking. Cindi Malone, a real estate agent just outside Nashville, has diabetes. And before the Affordable Care Act, she spent $1,700 a month on health care coverage for her family.

CINDI MALONE: That’s a lot of money, a lot of money for anybody.

SISK: Malone had doubts Obamacare would work, but moving to an ACA plan cut their premiums by a thousand bucks a month, so they made the leap three years ago. Those savings didn’t last, and this year she faced premiums higher than before the ACA because her income was too much to qualify for a subsidy.

Malone dropped out and bought a plan that wasn’t part of the exchange. It’s what she could afford even though the plan falls short of ACA standards and comes with a tax penalty up to $3,000. That’s what galls her the most.

MALONE: Just because I have insurance and you don’t like it, how can you penalize me? That makes no sense to me.

SISK: But the email Malone wrote to her congressman might be the most surprising part. It said if you’re going to repeal Obamacare, don’t go too fast. Wait. Get it right.

MALONE: And I am for repealing, but it’s not as easy as waking up this morning and wiping it out because there are people like me.

SISK: Tennesseans are among the least healthy people in the country with high rates of smoking, obesity and diabetes. That’s part of why the state’s insurance regulators last year approved the dramatically higher premiums people like Malone face. Regulators let the rates get so high because they were worried providers would pull out of Tennessee altogether.

And Republican Governor Bill Haslam’s plan to expand Medicaid, which might have taken pressure off insurers, was voted down by the state legislature. So now it’s on Tennessee’s members of Congress to find an answer, and at least some of those Republican lawmakers seem to be listening. Tennessee Senator Lamar Alexander gave a speech to urge caution.

(SOUNDBITE OF ARCHIVED RECORDING)

LAMAR ALEXANDER: Obamacare should be repealed, finally, only when there are concrete, practical reforms in place that give every American access to truly affordable healthcare.

SISK: Alexander’s views are important. He’s the chairman of the Senate’s health committee. That puts him in a position to steer the debate over repeal and replacement. Moving slowly sounds like a good approach to Sherry Cothran. She’s a Methodist minister in Nashville.

SHERRY COTHRAN: I just see a lot of at-risk people who feel very abandoned by the system.

SISK: Cothran is part of a group of ministers urging Republicans in Congress to have a plan in place before they repeal the law. She knows other forces are at work. Groups that have tried for years to reverse the Affordable Care Act can now sense victory. But she says a path can be found that preserves coverage for vulnerable Tennesseans.

COTHRAN: We want to see all of our political representatives on both sides of the aisle look at human dignity and look at our moral responsibility to people in general and put that before politics.

SISK: Cothran believes congressional Republicans are saying the right things about replacing Obamacare. The question on many Tennesseans’ minds is whether those words will translate into policies that protect them as the ACA is repealed. For NPR News, I’m Chas Sisk in Nashville.

Copyright © 2017 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.