morning , the military personnel
subcommittee of the Armed Services
Committee will come to order . I want
to welcome everyone to our hearing
Today to discuss the challenges of
service members that are facing
accessing reproductive health care .
The Supreme Court decision in Dobbs vs
Jackson women's health organization
overturned 50 years of precedent and
took away the established
constitutional right to an abortion .
The court stated that their opinion
merely returned the issue of abortion
to the states and that women can vote
for whom they wish to represent their
values , but service members do not get
to choose where they live . This leaves
230,000 service women who could be
ordered to a state that restricts
bodily autonomy jeopardizing our
recruitment and retention efforts .
There's a map that I want to show you .
This map shows the states that restrict
abortion in red Along with the
number of military installations within
those states . As you can see many
bases are in states where abortion is
or likely will be restricted . In fact ,
look at Texas where we have 19
installations and Florida where we have
17 installations . And in both those
states right now , um you can't get an
abortion under virtually any
circumstance One quarter of the women
will have an abortion before the end of
their childbearing years of the service
women currently serving in the military .
We'd expect that more than 50,000 of
them would have an abortion during
their lifetime and for many of them it
will be during their years of military
service even before the Dobbs decision ,
abortion access has long been a
struggle in the military , especially
for those overseas and junior enlisted
with lower incomes . Under current law ,
D . O . D . Is prohibited from
providing abortions except in cases of
rape , incest or a threat to the life
of the mother . These exceptions are so
narrow that D . O . D . Has confirmed
to me That only between
11 and 21 service members have
undergone an abortion at a military
facility each year over the past
five years . Think about
that . That means the vast
majority of service members are forced
to pay out of pocket not only for the
care they need , but also for other
expenses , including lodging , gas or
airfare and childcare . The Dobbs
decision will no doubt exacerbate these
challenges , forcing service members to
travel longer distances and shoulder
greater financial burdens . That is
if they are granted leave in the first
place , let me be clear . It is
inhumane to force women to remain
pregnant against their will . It is
arrogant to think that we know better
than a woman or her doctor about what's
best for her body . It is wrong to
create government mandated pregnancies
and I feel so strongly that
this is going to discourage women
to enlist to serve and to remain in the
military . It will become if it's not ,
if it hasn't already become both a
recruitment and retention issue . You
can put that down access to abortion
care is essential to a woman's health
and central to their economic and
social well being the ability to access
and abortion access and abortion should
not depend on how much money you have ,
where you live or where you are
stationed . That's why I've introduced
the march for service members act to
enable D . O . D . To provide abortion
care once and for all . My office has
been inundated with outreach from
former and current service members ,
anxious and despondent about being
stationed in states where they can't
control their bodies . One army
psychiatrist said to me and I quote ,
even I and some of my female physician
peers in the military with the relative
privilege of being officers and
physicians fear someday receiving
orders to a state which is banned
abortion because of this increased
maternal mortality in areas without
access to safe and legal abortion . I
would not feel safe attempting to
become pregnant in such a state
unquote . That is a comment by a
physician in the military at a
time when the military is struggling
with recruitment and retention . These
bands will certainly make matters worse .
In the aftermath of the dobbs ruling .
I'm asking the Department of Defense
how they are going to ensure service
members and their dependants who can
access the medical care they need and
deserve . We don't know how many
service members of reproductive age are
living in states with abortion bans .
We don't know , service members can be
denied leave or retaliated against for
needing an abortion . We don't know
what guidance medical providers are
getting so they can continue performing
permissible abortions . We don't know
what updated guidance leaders and
commanders are being provided when
approached by service members seeking
leave for medical procedures not
covered by tricare or offered in their
state . We don't know if military
treatment facilities will continue
caring all safe and FDA approved
contraceptive methods with so many
unanswered questions . It's no surprise
we needed to have this hearing and give
service members and medical providers
an opportunity to be heard . D . O . D .
Must act now to provide the right
resources at the right time at the
right place . So that service members
and their families who have no choice
about where they live continue to have
access to the reproductive care they
need want and deserve . As our
military members defend our freedoms ,
we must defend theirs .
I want to say to our first Panelist how
grateful we are that you have come
forward that you've shown the courage
that you have that you are speaking for
tens of thousands of women in the
military who serve around the world who
are finding themselves in the difficult
position of having to make these
decisions . The panel one includes two
service members stationed at home and
abroad who will share their personal
experiences . But Sharon Arana and Miss
Teresa Mazzello both will share their
deeply compelling stories of how
impactful access to timely abortion
care has been for them . Also on panel
one is dr Jackie LeMay and O . B . G .
Y . N . Currently stationed in
Washington State and working in a
military hospital and dr Godzilla
moya moya , who will tell us how she's
supporting service members stationed in
texas seeking reproductive medical care .
The second panel will include the
honorable Gil Cisneros , the
undersecretary for personnel and
readiness , as well as Miss Celine
mullen , acting assistant Secretary of
Defense for health affairs . Before
hearing from our first panel , let me
offer ranking member Gallagher an
opportunity to make an opening
statement . I think the chairwoman , I
want to thank all of our witnesses and
both panels for being with us today .
The mission of the Department of
Defense is to provide the military
forces needed to deter war and ensure
our nation's security . This is a
critical mission on that . We all agree
it's enabled by the readiness of the
armed forces , which is the ability of
the military forces to fight and meet
the demands of assigned missions and
the glue that binds mission and
readiness together is good order and
discipline . As George Washington once
wrote , discipline is the soul of an
army . It makes small numbers
formidable procure success to the week
and esteem to all . I start with
mission readiness and the need for good
order and discipline because our
military is predicated on men and women
following orders at times . That
includes going into harm's way if
necessary . The Department of Defense
and the services , therefore should not
consider a state's laws when making
decisions regarding service member
assignments . Nor should service
members be empowered to make assignment
decisions based on whether they agree
with the state's laws . I personally
believe that every human life has value ,
but that shouldn't make any difference
in the orders I'm given . Similarly , I
should not be able to tell my chain of
command where to send me based on
whether I agree or disagree with
state's laws with regard to the Supreme
Court's decision in Dobbs versus
Jackson and its direct effect on the
Department of Defense . My
understanding is there was no change to
the federal law that covers medical
services available to service members .
Nor are we suggesting it's necessary .
We cannot both maintain a functioning
military however , and allow
individuals to choose as Some in
Congress have suggested what
installation or assignment they can
receive on the basis of a pentagon .
Bureaucrats , perception of state law .
This very issue was debated during our
full committee markup and one of our
majority counterparts joined us on that
vote , the Senate Armed Services
Committee voted 18-8 . A strong
bipartisan vote to prohibit the
pentagon from using the agreement or
disagreement of a member of the armed
forces with the state's laws and
regulations applicable to any duty
station when determining the duty
assignment of the member following the
markup . Senator Sullivan the amendment
sponsor stated quote , allowing our
service members to veto the needs of
the service because they disagree with
state or local laws could lead to a
sorting of the military along
ideological lines that would devastate
readiness , unit cohesion and the
american people's respect for their
military . Senator Tim Kaine , a
democrat from Virginia who voted for
the amendment said that while family
considerations are important in
assignment decisions , quote .
Ultimately , military personnel
officials make the decision best for
the defense mission that is as it
should be . I agree with Senator
Sullivan and I agree with Senator Kaine .
The bottom line here is that allowing
state law to become a factor when
making personnel assignments is a very
dangerous and unworkable proposition
and a political professional military
is the hallmark of our american
democracy for hearing . Today . I'd
like to understand how the Department
of Defense will implement the june 28
2022 policy memorandum from Secretary
Austin on ensuring access to essential
women's health care services for
service members dependence
beneficiaries and Department of Defense .
Civilian employees , thank you and I
yield back . I thank the gentleman for
his comments . I want to just stay for
the record . This is not a hearing on
whether or not service members should
be able to choose where they serve .
It's a hearing to determine what we
should do to make sure they serve ,
where their order to serve and still
can receive reproductive health care
before we proceed with questions for
the witnesses . I want to add that
several service members approached my
office about wanting to share their
stories . Several has submitted
statements . I now ask unanimous
consent to add those statements to the
record of this hearing without
objection . So ordered
I ask unanimous consent that
members from the full committee
or other committees um who are inclined
to participate in this hearing are
invited to sit on the dais and
participate in the hearing . That
objection . So ordered
to the witnesses , we respectfully ask
that you summarize your testimony in
five minutes or less . Your written
comments and statements will be made
part of the hearing record . Each
member will have an opportunity to
question the witnesses for five minutes .
With that we welcome Miss Arana . You
may make your opening statement
and you need to push that button too .
Good morning chairman spear ranking
member Gallagher and distinguished
committee members . Thank you for the
opportunity to testify before you today
about service members reproductive
health and readiness . The views
expressed in this testimony are my own
and do not necessarily reflect the
official policy or position of the
United States Air Force , the
Department of Defense or the United
States government . I'm Sharon Arana a
major and intelligence officer in the
United States Air Force . I'm a prior
enlisted enlisted officer with 24 a
half years of active duty service In
the summer of 2009 . A week before
graduating officer training school . I
discovered that my birth control had
failed At the time . I was a single
mother of two , recently divorced and a
week from commissioning . When I
realized I had missed my period , I
asked my partner to take me to buy a
home pregnancy test . I didn't want to
go to the base clinic to get tested
there because it would prompt the
profile . I'm a chain of command would
instantly be notified of my pregnancy .
I also knew the clinic couldn't help me
find access to safe abortion . I didn't
feel comfortable testing in the dorms
where I was living while I was in
training . So I ended up taking the
pregnancy test alone in a gas station
bathroom . My then boyfriend ,
now husband and I had agreed that
continuing with the pregnancy was not
the right decision for us . We were
stationed in Alabama and access to
abortion was restricted . So the
weekend before we graduated training ,
we drove 3.5 hours to Atlanta . The
morning of my appointment , I learned
that Georgia had a three day cooling
off period , which meant that the first
day was only to confirm the pregnancy
with both a urine test and an
ultrasound that I was forced to watch .
I was expected to return to the clinic
in three days for the abortion . But
since I was in training , I needed to
return to Alabama to finish my course
in order to commission . Later that
week by chance , I had already planned
a trip to my hometown of Brooklyn new
york . After my graduation in new york ,
I had the access to the health care
that I needed and had an abortion . I
paid $400 out of pocket and I recovered
at home for a few days while on
personal leave before heading for
follow on training in Texas with my two
Children in tow .
About three weeks after arriving in
texas , I sought further medical care
after experiencing bleeding at the
clinic on base , I informed the nurse
that I had had an abortion a few weeks
prior . While my bleeding was a natural
part of my healing process and not
harmful to me . My nurse said she would
keep my abortion a secret and not add
it to my medical records just in case
I was confused and I felt stigmatized
for having an abortion . Like I was
being judged for the decision that my
partner and I had carefully made
together . I was never offered any
support or follow on care at the clinic .
Rather I was sent on my way back to
training without my pregnancy
termination ever documented in my
medical records
Choosing to have an abortion was not an
easy one . And it was the decision my
partner and I made together My husband
and I will be celebrating our 11 year
anniversary this year and we have never
doubted that choosing to wait to start
our family was the right decision for
us . We went on to have two more
Children together when it was right for
us and our careers . Our four beautiful
babies are a testament to the
importance of having access to critical
health care , including abortion .
We are a dual military family that
combined has over 40 years serving
an active duty , multiple deployments ,
years , stationed apart , missed
birthdays and anniversaries and
countless weekends and holidays ,
working missions and we wouldn't change
a thing . I know
that if I didn't have an abortion , I
would not have been able to continue my
training as a single mother and brand
new lieutenant going through officer
intel school . I also know that it
didn't have to be that difficult . I
was fortunate enough to come from a
state that honors a woman's right to
make her own decisions and I wasn't
forced to carry through with a
pregnancy against my will . I have put
my uniform on for the past 24.5 years
with pride and I'm honored to be able
to continue wearing it . My family and
I continue to make sacrifices because
we believe in what this nation stands
for . I believe that for everyone in
this chamber , the health and well
being of my fellow service members and
their families should be a top priority .
My husband and I would not have been
able to continue our military careers
had we been forced to carry that
pregnancy and as an unwed mother of two ,
geographically separated from my
partner and family . I would not be
where I am today . Our family the one
at home and in uniform has benefited
because I was able to travel to a state
that recognized that family building
decisions were ours alone to make . I
thank you for the opportunity to share
my story . Thank
you . Mr rana . Your testimony is
extraordinary and um you're
precisely who we want to serve in the
military and to have anyone snuff out
that opportunity for just um a lack of
providing services to our service
members um is repelling to me . So
thank you again for your testimony . Um
Miss Teresa Mazzello , who's an active
duty service member , is joining us via
zoom . Good morning
chairwoman , spear ranking member
Gallagher and distinguished members of
the subcommittee . It's an honor to
appear before you today to share my
personal experience . My name is
Theresa and Mazzello and I am a major
in the United States Air Force . My
comments today are my personal story
and do not reflect the views of the
Department of Defense , Department of
the Air Force , United States
Government or my current assigned unit ,
United States european Command . I
entered the Air Force as an active duty
enlisted member in 2000 to 2 weeks ago
I reached 20 years of military service
and I was recently selected for
promotion to lieutenant colonel . I'm
extremely proud of my military service .
I am thankful for all the opportunities
that has provided me throughout my
career growing up in a lower income
family in rural pennsylvania , the
military represented an economic step
up in a career path . I joined the
United States Air Force to see the
world serve my country and complete my
college education . I'm grateful . I
have accomplished these goals and so
much more . When I heard the news that
roe versus wade had been overturned ,
my heart sank . It was then I decided
to share my abortion story with others .
For the very first time , 19 years ago
I discovered I was pregnant at age 21 .
I was terrified at the time . I was
newly stationed at Whiteman Air Force
Base in Missouri . As an airman First
class E three . I was fresh out of
technical training as an aerospace
ground equipment mechanic . I was in my
work center for approximately 90 days .
I had no social support system
established yet . And as a first term
airman , I lived in a dormitory and did
not yet have a car . My bi monthly pay
was just over $550 . As a
relatively shy person . I only made one
friend so far . I was a female airman
and a male dominated environment and
the idea of discussing this personal
information with my leadership was out
of the question . I felt devastated ,
lost and alone . My dream of a
successful military career was falling
apart before I even had a chance to get
started . But looking back ,
I now realize how fortunate I was at
that time . I was fortunate . I was
fortunate I did not have to travel far
to get an abortion . I was lucky that
my only friend on base was willing to
drive me to an abortion clinic 90
minutes away along the Missouri and
Kansas border . I was lucky the clinic
was able to schedule my appointment on
saturday morning , so I bypassed the
need to request time off . This would
have been a critical hurdle . It was
shop policy that airman and upgrade
training were prohibited from taking
leave unless it was a compelling reason .
I could not imagine having discussed
such a personal matter with my male
leadership . After my abortion , I had
a whole day to recover my dorm room
before returning to work . That
following Monday morning at 7:30 , I
had access to the reproductive care
that I needed , but I had some
financial difficulties to overcome the
abortion cost my entire paycheck . I
had to wait until my next pay period to
repay my friend gas money for driving
me to my appointment . I was grateful
for having access to the on base dining
facility for meals and I scraped by on
a near empty bank account until my next
paycheck arrived without a question .
If I had not been able to have an
abortion . As a junior enlisted member ,
I would not have had my career and I
would not be in front of you today . At
the time of my pregnancy , I did not
have the financial ability , support or
personal desire to become a single
mother serving in the armed forces . I
know many strong service women who had
succeeded as single mothers , but deep
down , I knew that abortion was the
right personal decision for me today .
I'm speaking in support of women in the
military who will now have a much
harder time to access an abortion than
I did . I'm here today to give Airman
first class Mazzello a chance to tell
her story and hopes you consider it
when developing policy for women in the
armed forces . I'm especially concerned
for these junior enlisted members .
Like I was on a tight financial budget
who's now stationed in a state that has
banned abortion . Many will now need to
travel hundreds of miles away to find
an available clinic in a state that
recognizes the legal right to abortion .
Will they be able to afford the
transportation and hotel costs along
with the cost of an abortion ? Well ,
they need to ask their direct
supervisors for leave . Will this
knowledge compromise their careers or
will their privacy be respected or will
or will their situation become work
center gossip . But most importantly ,
what would their future look like if
they didn't have an abortion ? In
closing my heart is heavy after the
Supreme Court's decision . My story is
not unique . I personally know many
women who have faced much more
difficult circumstances accessing an
abortion while serving it deeply
saddens me to know that as I come to
the end of my career , my fellow
service women must face so many
additional barriers and challenges to
access the reproductive care they
deserve . They might not have the same
opportunity to succeed as I did . Thank
you again for this opportunity to
testify here today on such a critical
issue that involves the health and
economic well being of service women
and women in general . I look forward
to any questions . Thank you Major
Mazzello and like Major Arana , you
show extraordinary courage and
leadership and we're very grateful to
you for sharing your story . Now we'll
hear from Dr Jackie LeMay O . B G . Y .
N . At the Naval Medical . Who is a
naval Medical officer .
Dr LeMay . Oh yes , sorry I was having
some issues . Chairwoman sphere ,
ranking member , Gallagher and
distinguished committee members . Thank
you for this opportunity to testify .
Before I begin . I would like to
specify that I'm here today in my
personal capacity as a physician . The
views expressed in the statement are
those of myself and do not necessarily
reflect the official policy or position
of the Department of the Navy ,
Department of Defense or United States
Government . I'm dr Jacqueline LeMay .
I'm an active duty Navy gynecologic
surgeon and obstetrician and have
fellowship training in complex family
planning . I have been on active duty
for 21 years and prior to specializing
I spent five years in an operational
environment as a flight surgeon
including deploying to Afghanistan with
the marines both during my time as a
flight surgeon and even more so as an O .
B G Y N . I have seen how abortion
restrictions impact our service women
and active duty families . Active duty
women face unique challenges in
obtaining full scope reproductive
health care and witnessing . This led
me both to change my specialty to O . B
G Y N . As well as to pursue additional
training and complex family planning .
I'm honored to be here today alongside
my fellow panelists as they share their
personal stories . Abortion care is a
part of the full spectrum of
reproductive health care and should be
available to access no matter one's
reason for needing that care . One of
the hardest things I do as a physician
is tell a family that there is
something wrong with their pregnancy .
I've had to explain to patients that
while ending their pregnancy early was
a medical option . It was not something
that I could legally provide as a
military physician and I've cried with
families after their baby was born and
pronounced dead soon afterwards . One
person who comes to mind is the wife of
an enlisted airman . Someone who gave
me her consent to share her story today .
This was their second overseas tour far
away from family . I still remember the
look on the maternal fetal medicine
specialists face when she walked into
my office and asked me to join her in
talking with the couple about the
anomalies she'd seen and their options .
Their daughter Scarlett had severe
malformations that meant she was
unlikely to survive until delivery . My
patient asked about ending the
pregnancy and we talked about the ways
this could be done . I then had to tell
them that legally , since her life was
not at risk . I was unable to offer her
that option in a military facility and
it would not be covered by her health
insurance . If she wanted to end the
pregnancy , she would have to return to
the States and pay for the procedure
with no assistance from tricare her
care would cost thousands of dollars
plus the cost of international plane
tickets , hotel rooms and other
expenses . There was no way this young
enlisted family had the means for that
undertaking thankfully . She had an
amazing friend who set up a fundraiser
for the family and within a few days
they had an overwhelming response and
enough money to access the care she
needed . When she returned , she told
me that everyone in the clinic was
wonderful , but she wished that I had
been the one that had been there with
her throughout this entire process .
While my patient in this case was able
to get the care she needed so many of
my patients do not . They should not
have to share their stories publicly or
ask for financial help from strangers .
Time is also a concern for active duty
women . They must request leave from
their commanding officer who may deny
it or ask for details , forcing them to
disclose their personal medical
information to someone who is not
actually involved in their medical care .
I worry about my patients , no longer
being able to access the care based on
where they're stationed as active duty
members . We do not get to choose where
we live . We have volunteered to
protect our country and remove every
few years from state to state and often
overseas to fulfill that mission , we
cannot choose the laws under which we
are held depending on our duty station ,
our healthcare as military members .
Independence should not be based on the
current duty station , but on
consistent federal standard of care for
military members and their dependents .
In closing , I want to share how
thankful I am for the recent memo from
from scarcest narrows . Reaffirming
that we in military medicine can and
will continue to provide reproductive
health care within the scope of federal
legislation . But more needs to be done .
I urge you to provide federal
protection to both patients and
physicians who provide these legal and
needed services on federal land . I
would urge you to go even further .
While I truly hope to see the Hyde
amendment overturned at the very least ,
I urge Congress to remove the
restrictions that do not allow patients
to self pay for abortion procedures at
military treatment facilities as it
exists for many other procedures
covered by tricare preventing the same
option for abortion services is not
only discriminatory , it impacts the
readiness of our armed services . And I
fear the impact will worsen with
unequal state restrictions that force
patients to travel long distances and
take leave to obtain the care they
deserve and so desperately need . Thank
you .
Thank you Dr LeMay for your um
profound comments . Um , we now welcome
Dr gazelle Amoia D . She is a texas
based civilian O . B . G . Y . And
whose services ? Uh service members
welcome .
Good morning . My name is Dr Castle , a
mortuary and I use she her pronouns .
I'm a board certified O . B . G . Y . N ,
a child of Iranian immigrants , a mom ,
a Texan and a proud abortion provider .
I serve on the board of directors for
physicians for reproductive health and
texas . Equal access fund , abortion is
essential health care . Every person in
our country has the human right to
decide for themselves when and if to
start a family . And that includes
members of the armed Forces as an O . B .
G . Y . N . I know firsthand that safe
birth healthy families and thriving
communities require access to abortion
care , abortion bans disproportionately
harm structurally oppressed communities
and members of the Armed Forces Service
members and their families are often
far from their homes , young and living
on low incomes . Few have the resources
needed to him urgently access time
sensitive abortion care . While I can
talk at length about the impacts of
abortion bands on the many communities
that I serve today . I will speak about
my experiences caring for members of
the military Before becoming a
physician , I worked for an abortion
provider in Austin near Fort Hood . We
routinely cared for service members and
I witnessed the countless obstacles
they endured to receive abortion care .
They struggle to obtain leave for
procedures , get rides to Austin from
base pay for their care and even get a
referral on where to go because of the
culture created by unjust policies like
the Hyde amendment . The ability to
find our clinic often depended on one
person on base who was willing to
secretly give people our brochure
essential health care for our armed
forces hinged on a whisper network for
those who did manage to find us . I
can't even begin to describe the pain
service members expressed when we would
explain your tricare won't cover this ,
you'll have to pay out of pocket .
After becoming a physician , I spent
part of my training and gynecologic
surgery on base at Fort Bliss from
previously working near Fort Hood , I
remembered caring for countless sexual
assault survivors at our clinic , even
though they technically should have
been able to receive that care on base .
Once at Fort Bliss , I realized the
problem to actually access abortion
care on base . Everything must line up
perfectly for the survivor . I was only
able to care for one such person at
Fort Bliss thankfully , her commanding
officer was supportive so she was able
to obtain the necessary authorization
for her abortion . As members of this
committee know it can be incredibly
daunting for a service member to report
an assault committed by another member
of the military . I was grateful that
everything worked out for this patient
to get the care she needed . But this
is not how healthcare should work for
members of our military after residency .
I did fellowship in Hawaii , a state
with a large military population and a
critical healthcare destination for
service members stationed in Asia .
Hawaii has excellent abortion access
and many residents can receive
financial and transportation coverage
for their care . That is except those
members of the military . I will never
forget weeping . After sitting with an
unlisted service member who needed to
count out quarters to afford her care .
She asked me what parts of pain
management she could forego , so she
could afford her abortion . She assured
me she was strong enough to not need
pain medication . I was changed forever
bearing witness to that injustice . I
remember another patient who was raped
by a fellow service member while
stationed in Asia feeling unsafe . She
could not report or seek help from her
commanding officer . She couldn't find
care where she was stationed and it
took several weeks to be able to fly to
Hawaii for care Because of the
significant violence she endured . She
would have ideally had her abortion
under deep sedation , which is not a
requirement for safe abortion , but
might be necessary for trauma survivors .
But access to anesthesia makes the cost
of care considerably higher , sometimes
over $10,000 . Since she was paying out
of pocket . She had her abortion with
just numbing medicine in our clinic
while I provided skilled and
compassionate care . It was devastating
to see someone dedicated to serving our
country abandoned by it . We wept
together after her procedure . I was
honored to be trusted with her care and
she should have never been forced to
come all the way to me to access her
right to an abortion . I'll end by
saying that we should all be incredibly
angry at the systematic denial of
reproductive autonomy that is happening
to millions of people in our country .
As we meet today . Nobody deserves to
suffer the indignity of counting
quarters to pay for medical care for
going medication , to alleviate pain ,
traveling thousands of miles for basic
health care or having whispered
conversations about where or how to
access care . These things happen every
day to our service members and two
civilians in every one of your states .
I envision a world where everyone has
access to culturally relevant abortion
care in their own communities . This
committee's jurisdiction is the armed
forces . So I will say I will implore
each of you to at least make this world
a reality for our service members .
Thank you for having me today . Thank
you doctor . Um again , extraordinary
testimony . Uh and it pains me as I'm
sure it pains many of us to hear these
stories . But their real stories um
paying extraordinary sums of money to
travel and get an abortion because they
can't access an abortion at a medical
treatment facility . And to look at the
states again , that have
basically banned all abortions
and have criminalized the providers
for giving women
abortions . Um is also
compelling as well . Let me start with
um asking the two physicians is
one of the letters that I received was
from an army psychiatrist and she wrote .
The risk of postpartum depression can
be particularly high for unwanted or
unplanned pregnancies and for women
under significant stress . Military
women are known to have higher rates of
unintended pregnancy . Um Oftentimes um
125% of the regular population
and they may face unique stressors
related to an unplanned pregnancy ,
including the physical and emotional
stress of their work . The effect of
pregnancy on one's career and the
difficulties obtaining adequate
childcare for long and unpredictable
work hours . Military women are
therefore understandably concerned
about access to reproductive health
care . Even before roe was overturned ,
I worked with female patients
distraught about receiving orders to
post in texas after the texas heartbeat
act was passed . Some of these women
are already in a fragile emotional
state and have the self awareness to
realize they are currently unequipped
to whether the mental and physical
stress of pregnancy , much less
motherhood , others have prescribed
medications contraindicated in
pregnancy , but essential to their
mental stability . Female service
members may lack the financial means to
travel for an abortion . They require
permission from their chain of command
even for weekend travel if it is beyond
a certain radius and they may not trust
the military to protect their privacy .
Should they request such travel to
obtain an abortion ? Even I and some of
my female physician peers in the
military with the relative privilege of
being officers and physicians fear
someday receiving orders to a state
which is banned abortion because of the
increased maternal mortality in areas
without access to safe and legal
abortion . I would not feel safe
attempting to become pregnant in such a
state . So dr LeMay and dr
moody . Um that's a pretty
extraordinary statement from a
psychiatrist , behavioral health
provider about the impacts of state
restrictions on health care for service
women as O . B . G . Y . N . S . What
are your assessments of the impact of
Dobbs decision on the ability of
military and civilian health care
providers to provide care to military
personnel ?
I can take this one if you want Doctor
Moretti . Um , thank you congresswoman .
While the recent statement from the
undersecretary makes it clear that we
in military medicine can and will
continue to provide health care . Um ,
under current federal legislations ,
there are still many questions that
remain both for patients and for
providers in various locations . I'm
lucky I'm currently stationed in
Washington state . So nothing changes
for me , but for some of my colleagues
who are stationed in texas or florida
or Georgia or overseas , there are most
physicians live out in town . So there
are questions on if they provide an
abortion procedure that is legally
allowed , but then go home , can they
be arrested ? Can they be tried with
something and who's going to help them
pay for that ? Because that the cost of
that can be devastating . The same
question exists for many of our
patients if they get a legal abortion
procedure on base , but live in one of
these more restricted areas and have
bleeding or concerns and go to the
emergency room , are they going to be
arrested and for something that they
legally obtained on base ? Um I think
that that is one of the questions that
still exists and one of the fears that
I have heard both from patients and
from my colleagues who are in more
restricted areas over the last month or
so . Thank you . Thank you . Dr moody ,
thank you . And you know , I'll add
from what you heard in my testimony and
what from the other witnesses have
testified today , the majority of
abortion care provided for members of
the military does not happen on base .
It happens off base . So when we're
talking about a state like texas , that
means that no one right now that is
stationed here has access to abortion
care . The nearest states . Right ,
what are we talking about ? Oklahoma
doesn't have abortion care anymore .
Arkansas doesn't have abortion care
anymore . Alabama doesn't have abortion
care anymore . And so we're not just
talking about going over to the next
city now , which was already a huge
hurdle for many , many members of the
military . But we're talking about
traveling hundreds , thousands of miles
to be able to get what is very basic ,
simple safe , essential health care . A
first trimester abortion takes about
3-5 minutes to complete . But someone
from Texas stationed at Fort Hood might
travel for two days to be able to
access that procedure . Now , thank you .
Um Major Arana and Major
Mazzello , what are some of the
barriers facing Service women who seek
an abortion ? And what have you heard
from service members about their
concerns about being stationed in a
state that bans abortion . Good morning ,
thank you for the question . So um man
for non tricare covered abortions .
There's minimal to no support . Um
while recent changes in the Air Force
instructions removed the need for
commander's approval for the procedure .
Members are still left with the burden
of taking personal time off paying for
travel um out of pocket expenses for
the procedure as well , that these
restrictions also as mentioned earlier ,
disproportionately affect training
bases where members have less access to
resources and experience additional
barriers to travel or leave due to
their training status . Major
Mazzello . Thank you ,
ma'am . I would say the challenges are
extremely worse today . The bi monthly
base pay of an E one with less than two
years of service is a little over $900 .
Even if the service members ultimately
able to reach a clinic , they're gonna
face significantly longer wait times
increased costs due to the travel , the
lodging , the childcare and more
expensive procedures . They require
multiple trips to the clinic . And this
would add more and more costs . Not to
mention more and more time off . How
many levels of leadership will the
leave requests need to go through ? I'm
so concerned about their privacy and
mental health . Can our junior members
afford these costs ?
Do you think that this is going to
discourage women from serving in the
military ? Absolutely ,
yes , ma'am . Just yesterday I shared
this uh hearing with one of my
coworkers . A fellow service member , a
man . Um He shared with me that his
wife needed an abortion after an
ectopic pregnancy . He stated without
timely access to this life saving
procedure . His wife could have died to
see this strong individual . A friend
stand in the hallway with almost having
tears in his eyes while he recounted
this story . It was so impactful . He
could have been an active duty service
member with a small child in a widow .
This was prior to the reversal of roe
versus wade . We further discussed the
concerns and what if he was stationed
in a state that now bans all abortions
access to reproductive care matters to
the life of fellow military members and
our families , both male and female .
And this court's decision affects us
all again . Thank you both for your
extraordinary participation . Today I
now yield to the ranking member . Thank
you . Um I think we all agree that the
assignment process uh and first of all ,
thank you all for again for being here
and sharing your stories . Um uh The
assignment process is the means by
which the military make sure it has
people in the right assignments to meet
its mission requirements , both in the
continental United States and abroad .
So the service is right orders to unit
X . For a service member to go into a
billet or a job because there's a
military essential task that requires
specific skills and knowledge . So
looking to the future , let's say you
are given the choice to be assigned .
And I guess I would ask both Miss Arana
and uh Miss Mazzello and dr LeMay this
question um If you if you're given the
choice to be assigned to an
installation based on laws that were
favorable to your political beliefs ,
whether it's a pro life state or a pro
choice state or something else , let's
say a state had a concealed carry law
that you didn't agree with or there's
another issue out there or maybe
there's an office in D . O . D . That's
creating an assignment matrix of red
and blue states based on existing
policies . I mean because I've
articulated I think the potential
ramifications for that . Um And for for
D . O . D . And the service is trying
to manage a system like that and for
service members that now need to put
sort of politics in their service
assignment equation gets unworkable
pretty quickly . So I guess my question
is whether you think that that personal
preference for an assignment should
supersede a validated military
requirement for your service to assign
you where they need you if that makes
sense . Start with you . MS . Arana .
Thank you sir . So again we're not
talking about assignment and the
assignment process here and I do
believe that the end of the day it's um
the needs of the military um because
that's why I'm here and that's why I
serve . Um I do believe though that as
a serving member , I am also owed a
standard of care and we talk about
access to healthcare and standardized
health care that shouldn't change based
on the state that I am stationed . I
have four daughters and I would
hesitate to take any of them to a state
where I know that their bodily autonomy
is not going to be respected . I don't
believe that this is a um political
issue as you stated earlier . I believe
that a person's health care should be a
discussion between the member and their
medical provider . Health care
shouldn't be politicized . I shouldn't
have to be here today telling my
private story in this very public forum .
But I am here today in the hopes that
by telling my story , I humanize this
issue and and bring to light highlight
that health care is not a political
issue and it's not about political
leanings . It is about understanding
that everyone has the right to
comprehensive medical care to include
abortion access . And I hope that with
this discussion and with this hearing ,
we can redirect this conversation and
understand or accept that the welfare
safety of our service members and their
families that are also affected by
these policies become the priority .
Thank you . Thank you Mismo
Zillow . Thank you for your question .
Um , this is a question of healthcare ,
not political views . So I can say
without a without a question . If I had
not access to an abortion as a junior
enlisted service member , I would not
have served in your military for the
last 20 years . A service women's
access to reproductive care should not
depend on what state they are stationed
to texas , Arizona florida
Georgia Ohio south Dakota Oklahoma
Missouri Arkansas Mississippi Alabama
and south Carolina . They're all homes
of large military installations and now
they almost fully or almost ban
abortions . Please think of the story ,
I just told you about that mail service
coworker . This makes me fear for all
my fellow service members . I'm sharing
My story because I care about access to
safe reproductive care , not political
views . And I care about my sisters in
the armed forces . I believe we all
deserve this right . No matter what
state what state the military sends us
to as service members , we defend your
freedoms . Please defend mine and my
access to reproductive care . Thank you .
Thank you . I only have 30 seconds left .
So I apologize to other witnesses .
Unfortunately , I think , I mean ,
health care , the reality is is an
intensely political issue in so much as
the political process is how we make
decisions on how health care should be
provided . And that's what we're
working through right now . Very thorny
questions about health care should be
provided . And the reason I focus on
this issue of um , assignments and
whether service member preference
should supersede . Uh , the law of the
land is that is what was initially
suggested by the pentagon . And that is
what occasioned the debate in this
committee and in the Senate . And
that's what we're trying to work
through uh , in good faith , uh , right
now . So I look forward to the day when
there's a , I guess a less politicized
discussion on health care . But it's
been my observation in in six years of
being here that it's a very , very
difficult topic that requires us to to
talk about it through the political
process . I'm out of time ? I apologize .
I thank the gentleman . Um , I have a
question . Uh , do you think that
service members should have to take
personal leave in order to access the
health care that's not available to
them at their military treatment
facility ? Yes . Do I think that
service members should have to take a
personal leave in order to
access to like to go get an abortion in
the state where it's legal , correct ?
Well , in the current system right now ,
would it be illegal for some for the
command to grant them leave to get that
to get an abortion in a different state ?
I don't , but well , we can ask that ,
certainly of um the Under secretary ,
but I think it's the fact that we don't
offer the healthcare at the military
treatment facility where they are means
that they then have to take um they
they're what leave they have and use it
to get healthcare , which seems like
it's once again another punitive step .
And I think , I think you and I are on
the same page when you talk about ,
there shouldn't be an ability to pick
the state in which you serve . But we
have 100 and two installations right
now on that map , 102 installations in
the United States that will in which
the state's ban totally ban
access to abortion care . I mean ,
that's an extraordinary number . We
have another 29 installations where
they're about to ban abortions . So ,
you know , we've got to take a step
back and recognize that um you can't
on top of forcing these service members
to go large distances to get an
abortion , that we're then going to
penalize them with the costs associated
with the travel and lose
their vacation time . What little there
is , I mean , we're creating a real
incentive for women not to serve and in
some respects , it's almost an
insidious effort to encourage women to
leave the military . And that's the
last thing that I wanted to say . I
think I think we're trying to do here
today and obviously we have
disagreements on both sides on this
issue and I'm not sort of , you know ,
I hope you appreciate the spirit in
which I'm engaging in this debate is to
work through all of these these uh
issues and understand what the D . O .
D . S proposed policy is , understand
all of the issues associated with a
post Dobbs role . Uh my understanding
in that particular instance , it I
think , and then you can correct me .
One issue is that it would run into the
Hyde amendment . Right . We would then
have to fund the actual ,
potentially , potentially . But again ,
that's what that's what we're working
through here today . I think in good
faith . Okay , Alright . I thank you
for that interchange . Um I now
recognize Miss Hoolahan for five
minutes . Thank you Madam Chair . And I
really do appreciate the spirit of a
conversation . I was that one person
who voted on the other side of the
aisle that said that we shouldn't be
able to pick where we're serving . I
served in the military myself . My dad
and my grandfather more than 30 year
careers , each of them as well . And I
remember being a young girl um moving
around almost every single year and my
father would say , we don't get to pick
you know , where we're going . And so I
really , really appreciate Miss Ariana
Iran . I think you and I share that
sort of sense of the on the needs of
the military drive where it is that we
need to be . But I am so enormously
compelled and appreciative of your
testimony both of you Because when I
served , I was a young mother as well .
And I remember having very limited
leave and not being able to travel . I
cannot remember it was such a long time
ago whether it was 90 miles or 90
minutes without having to request leave .
Uh and so that would have certainly
limited my opportunities had I needed
to make those kinds of decisions for my
own health care . And I'm also
wondering back to my own mother who was
a military , a navy mom as well as my
grandmother , Navy mom . And they had
their Children and my grandmother's
case seven Children in my mom's case to
um what the sorts of decisions and
choices that they may have had to make
while they were naval moms as well . So
I thank you very much for your bravery
and your uh enormously compassionate
and articulate um expression of this
personal journey that you've . Would
you be able to talk a little bit more
about the privacy issues that you both
of you talked about ? I remember um
also struggling with whether or not to
share certain issues of mental health
while I was active duty . Would you be
able to talk a little bit more about
why you felt as though you needed to
hide or not discuss these kinds of
things with your chain of command .
Miss Ariana , please thank you
congressman for the question . Um I
believe that in the military there is
still a stigma surrounding this topic .
Um just you know , even coming here and
before I was able to come here in the
statement I have to give and make sure
that it was understood that these are
not the Air force's views and these are
mine personally . Um it makes it really
hard and difficult to talk about this .
Um while we say that , you know , I
talk a firm believer , we shouldn't be
politicizing our health care issues .
When I am at work , I can talk about my
mental health care issues because that
is the thing that's encouraged , you
know , let's be open and let's be
transparent and and let's help one
another out . But when we talk about
abortion specifically , this is not a
topic that is except in the office . Um
we don't speak about this . We
definitely it's amongst friends only .
Um , you don't advertise it because you
don't know who you work for and you
don't know what their views are on this .
And if you have a supervisor , um , who
doesn't support your decisions , it
could always come back to you as well
and punitive effectively . Um , but yes ,
it's a very uncomfortable situation to
be in . And the fact that we have this
culture where our policies also don't
support it . That just enforces that
stigma . You know , um , we're not
taught to , we're not educated in the
military on what our rights and our
accesses are with regard to accessing
emergency contraceptives or you know ,
whether it's rape , incest or life to
the mother that you can have tricare .
Most people don't know this information
because we're not told either . And
unless we go out as service members ,
both men and women seeking this
information ourselves . Um , and doing
the homework . It's , it's not
advertised to the rest of us . Thank
you . And I'm sorry to interrupt cause
I only have one more minute . I have
one other question for the doctor as
well , which is , would you speak a
little bit to miscarriage . Uh , and to
your experience in this particular very ,
very common occurrence and how both
either active duty women or or spouses
are experiencing that with relationship
to abortion access and health care .
Um , so I can speak to miscarriage care
in my state off of base not having a
first of all restricting abortion
access always impacts all pregnancy
care . And so the fact that abortion is
now illegal in the state of texas makes
pregnancy in general more dangerous .
Over the past year , we have been
seeing that physicians across the state
have been delaying lifesaving
interventions for miscarriage care
because they are worried about how they
intersect with the abortion bans in our
state . They've also been delaying
lifesaving interventions for ectopic
pregnancy care again , because they're
worried about how abortion bans
intersect with the care of pregnancy
complications . So it is um , it should
be a huge concern for service members ,
Service members , spouses that are
stationed in States with abortion bans ,
how they will be treated and how their
lives will be valued throughout their
pregnancies . Thank you . My time has
expired and I yield back , generally
yields back . The gentleman is
recognized Mr kim for five minutes .
Thank you . Chairwoman . Thank you all
for me . Um I apologize Mr
Fallon has joined us . So , um we will
turn to Mr Fallon for five minutes .
Thank you , madam . Chair . I don't
have any questions for this panel .
Thank you . I yield back . The
gentleman yields back . The gentleman
from New Jersey is recognized for five
minutes . Okay , I'm back . Um I just
want to say thank you from the outset
here for all of you and your
testimonies um in the
3.5 years or so that I've been here in
Congress ? I've had a lot of hearings
here in this committee room and I have
to say , I believe this one to be just
just at the top in terms of the most
powerful ones that I've been a part of ,
um , to be able to hear your stories
firsthand . I want to thank you for
your willingness to come forward and
share that with us . It's important for
us to hear this for me . I've never
served in uniform . Um , not a woman .
I'm not a mother for me to be able to
understand your perspective . Um , what
you've gone through your experience ,
it's invaluable . So I want to say
thank you when I hear your stories .
Something that really stands out pretty
much in every single one is about how
some circumstance came about , that
helped you along this path . Mr rana .
You talked about how you just happened
to be having a trip back to your
hometown in Brooklyn , Is that right ?
And I think MS Mozilla mentioned that ,
you know , just happened that there was
one friend that could bring her forward
and I I just get really moved by
that that just these circumstances just
came about and and it just bothers me
because it shouldn't have to hinge on
just that kind of for your
circumstances . Mr rana . Just brute
luck that you happened to be scheduled .
I wanted to ask you , What do you think
would have happened , had you not had
that trip scheduled back home ? Thank
you for the question . I know what
would have happened is um would have
been one of two things if I wouldn't
have been able if I would have been
forced to carry through with the
pregnancy because I was on my way to
technical school to intel officer
school in texas . Um my training either
would have been curtailed or I would
have been sent to another station . It
would have affected the entire path of
my career . And
Mismo Zillow , you told the story about
how you didn't know very many people
there and there was one person that was
able to drive you . What do you think
would have happened ? Had you not met
that person , had that person not been
willing to help you out ? Thank you for
your question . I thought about that
too many times and many times I joined
the air force for an economic step up
in a career where my life would have
went if I didn't have that abortion . I
have no idea and I truly , truly value
and credit that abortion provider 19
years ago for where I am today and I
couldn't tell you where my life would
be . But I know one thing I wouldn't be
standing here before you today telling
my story and trying to make an impact
for my fellow service women . Thank you .
Thank you . It just really hits me
because you know we're here on this
committee trying to make sure that you
have the services that you need , the
infrastructure you need to be able to
and serve our nation and and for this
for your own choices to come down to
just these , these circumstances ,
these happenstance of of trips and and
people to be able to help out . It just
shows and reinforce it to me just how
broken of the system , how we failed
you in terms of being able to provide
you what you needed . Mr rana . You
were saying that this was all happening
when you were graduating from officer
training School . Is that right ? And
I'm sure that a part of that officer
training school program was about um ,
you know , your physical well being and
training and and exercise , is that
correct ? So obviously a big part of
that was about your health care , about
making sure that you're physically fit
to be a service member and being able
to to exercise the duties of that
position . Is that correct ? Would you
say that your health care when it came
to having an abortion ? That that was
something that would have affected your
well being , your health care , your
ability to be able to do your duty .
Absolutely . I think that you know , we
as military members , we have a
responsibility to remain worldwide
deployable . Um , and I think but yet
when it comes to abortion specifically
we are completely abandoned by the
system and left to the luck of where we
are stationed , you know . Um , I want
to also point out that a lot of basis
right now do not have sufficient
obstetrics care for its military
members . So even active duty and
dependence . And I want to highlight
that this doesn't just affect me and
the women in uniform , it affects the
family members as well , the dependence .
Um , so we are beholden to civilian
services . Um , out of my four kids ,
only one was born in a mill , the
hospital and the other three were all
in civilian hospitals . So it makes
this even more prudent more important
to make sure that we are creating an
access , a standard of access of care
across the board that is completely
lacking right now . We should have done
better for you . And I hope that this
committee can do better for many others
that are going to experience these
types of challenges going forward .
Thank you . Gentlemen yields back