Politics Distorts Facts on Impact of Abortion Coverage


CORRECTION: A correction to this article was made on Wednesday, August 5th 2009 at 12:24 pm to the following sentence: "Some abortion opponents have claimed that continuing to allow private plans to cover abortion, as most do now,
somehow would lead to an increase in the number of abortions in the
United States of 300,000 (25 percent of the current 1.2 million each
year
)."  The earlier version erroneously stated…"(2 percent of the current 1.2 million)."

This article, an RH Reality Check exclusive, is a preview of an article in the forthcoming Summer 2009 issue of the Guttmacher Policy Review, which will be available at www.guttmacher.org in late August.

Earlier this year, the Guttmacher Institute published a series of comprehensive literature reviews assessing the impact of three of the most prominent federal and state policies aimed at restricting access to abortion.

A team of researchers from Guttmacher, Baruch College and the Graduate Center of the City University of New York, and Ibis Reproductive Health found that state laws requiring parental involvement in a minor’s abortion or mandating state-scripted counseling and a waiting period may delay abortions (thereby making them more expensive and dangerous) but, by and large, do not have a substantial impact on actually preventing them from occurring. (Laws requiring a waiting period following in-person counseling, which by definition necessitate two separate visits to the facility, are a possible exception.)

In sharp contrast, the researchers found that the ban on federal Medicaid coverage of abortions for poor women—commonly known as the Hyde amendment—does have considerable impact: One in four women who would have an abortion if it were paid for by the government instead continue the pregnancy to term.

If the ban on public funding denies women access to abortion, it should go without saying that restoring public funding would have the opposite effect. The extent of an increase in abortions if the Hyde amendment were to be repealed, however, may not be so obvious. Antiabortion advocates contend that if the Hyde amendment results in a 25 percent reduction in the number of women on Medicaid who obtain an abortion, its repeal would result in a 25 percent increase—which they imply would have a significant impact on the U.S. abortion rate.

Neither of these contentions is true. In fact, an unpublished study by Guttmacher researchers estimated that if subsidized abortions were to become available in those states in which they are not currently available, there would be a 28 percent rise in the number of abortions among Medicaid-enrolled women in this group of states.

Still, that would translate to only a 5 percent increase in the total number of abortions in these states, because relatively few women in any given state are actually enrolled in Medicaid. And because many of the most populous states (such as New York and California) already use their own money to pay for abortion services for poor women, the national impact of repealing the Hyde amendment would be even smaller: The number of abortions among Medicaid-eligible women nationwide would be expected to increase by approximately 33,000, a figure that would represent an increase in the number of abortions nationwide of only 2.5 percent.

This analysis would be relevant if there were an active debate in Congress about repealing the Hyde amendment. Unfortunately, that is not the case. Rather, the current debate is around health care reform, specifically over the question of whether health insurance plans will continue to be able to cover abortion services. (There is no serious chance that private insurance plans will be actually required to cover abortion.)

Some abortion opponents have claimed that continuing to allow private plans to cover abortion, as most do now, somehow would lead to an increase in the number of abortions in the United States of 300,000 (25 percent of the current 1.2 million each year).

Their numbers and their policy conclusions could not be more wrong.

Even taking into account the fact that more women at risk of unintended pregnancy than is now the case would have health insurance if reform succeeds, some of these women would be enrolled in an expanded Medicaid that would not pay for abortion. Others are higher-income women for whom their current lack of coverage is not nearly the impediment as it is for poor women. Therefore, the availability of coverage, while important at the individual level, cannot be expected to increase the overall numbers of abortions more than nominally—if at all.

Antiabortion leaders, meanwhile, are taking another giant rhetorical leap when they misuse the Guttmacher data to take President Obama to task for violating his supposed pledge to reduce the number of abortions in the country. In fact, the president has been careful to not say that he supports reducing abortions by any and all means. Rather, his pledge was to reduce unintended pregnancies and the need for abortion. And that is why he is advocating for evidence-based sex education and increased access to family planning services, thereby giving women the information and the means to do just that.

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  • invalid-0

    You continue to use divisive labels because that’s all you have in the case for abortion on demand. Most civil, rational, intelligent people realize that abortion is the killing of an innocent human, who is a completely separate person from the mother, no matter what stage of pregnancy.

    Just as we are not allowed to kill another post-born human, we should not have the right to kill a pre-born human. If the bar of humanhood is independent viability, then let’s clear the hospitals of all the sick and shut down pharmaceutical companies as all they are doing is helping people who cannot survive on their own.

    Your whole mission and agenda is to keep making money off of dead babies and it is one that will be lost.

    • http://www.angiecoiro.com invalid-0

      Speaking as a journalist, my job is accuracy first, respect a very near second. Respect requires me to call a person or group by the title they prefer, and I do that whenever possible. But if their preferred title is inaccurate or deceptive, accuracy moves to the fore.

      “Pro-life” acts in essence as a marketing term. Nearly every human being is pro-life; the difference in opinion centers on when “life” begins. To allow one group to claim the “pro-life” title implies – inaccurately – that an opposing view makes one “anti-life”.

      Most specifically, these are people and organizations that want to stop abortion. Thus, they are most precisely described as “anti-abortion”. The abortion is the center of controversy.

      Anti-abortion groups prefer to label their opponents as “pro-abortion”. This is not accurate, either. These opponents don’t promote abortion per se; they promote an individual’s *option* with regard to abortion. “Pro-abortion” makes no more sense than “pro-(any surgery)”. One doesn’t go around encouraging everyone to have lung transplants (“pro-transplant”), but should a person need one, and should it not conflict with his or her moral code, they’d like it to have that choice.

      Another small but important distinction: many pro-choice voices are in fact opposed to the procedure (personally anti-abortion), but wish to keep the legal option available for others.

      Thus, “pro-choice” is the most precise and accurate term for the opponents of anti-abortionists.

      The rest is spin.

  • invalid-0

    Right. It’s not AT ALL divisive or labeling to imply that those who accept the scientific fact that a fetus is not a person are not civil, rational, or intelligent.

    Regarding the rest of your “argument,” if you were as civil, rational, or intelligent as you think, you might be familiar with a Latin phrase “reductio ad absurdum” which—if I’m correctly recalling the Latin I learned in Catholic grade school—roughly translates to “nobody is suggesting anybody close hospitals and drug companies, you fool.”

  • paul-bradford

    Not enough attention is being brought to the fact that, currently, uninsured women procure abortions at a disproportionally high rate.  It’s easy to see why.  The woman who doesn’t have health insurance has to fully pay for the hight cost of pre-natal and pediatric care and would actually realize a financial gain if she chose to abort. 

     

    To restate: Uninsured women are being subsidized to abort their children.  Women who have a choice about health care options are more likely to bring their pregnancies to term.

     

    You may argue that repealing the Hyde Amendment would be ‘pro-abortion’.  Perhaps you’re right, but it could never be as pro-abortion as poverty is.  If you really care about the well being of the very young you should be doing everything you can to advance Health Care Reform. 

     

    Paul Bradford

    Pro-Life Catholics for Choice

    • invalid-0

      I was thinking you were a member of ‘Catholics for Choice’. (Haven’t heard of your group.) That group actively undermines the teachings of the church which it identifies with- and is not legitimately a Catholic group. I shouldn’t have questioned your Catholicism. I do dispute that you are ‘pro-life’ (pro-life and pro-choice are mutually exclusive- although some people are neither), but that’s a different issue. I retract my characterization of your spirituality. (Sorry about that- I regret it.)

  • therealistmom

    … but these is so much truth in this statement. While I don’t think the majority of women would choose not to abort if they had health care (most who choose do so for many factors, not only financial, I and I will always back whatever reason a woman chooses not to continue a pregnancy) there IS a segment right now with the recession and lack of available care who likely are aborting pregnancies they might otherwise have welcomed, such as a painful choice for a married couple where income is no longer there. Health care reform is good for potential children as well, when women are able to afford adequate prenatal care to help ensure the delivery of a healthy baby.

  • invalid-0

    One can not truly be pro-life unless she/he is against the death penalty. This is why the term anti-abortion, and not pro-life is used.

    If you’re against the death penalty too, then you are pro-life. Until that time, you are an anti-abortionist.

  • invalid-0

    < ...Some abortion opponents have claimed that continuing to allow private plans to cover abortion, as most do now, somehow would lead to an increase in the number of abortions in the United States of 300,000 (25 percent of the current 1.2 million each year)....>

    There they go again.

  • invalid-0

    Get serious!
    There are no scientific facts about what a ‘person’ is. There are scientific facts about when the life of a new human being began. The fact that the “pro-choice” movement falsely asserts the converse is either evidence of ignorance or of dishonesty.

    1) Any legitimate biology text will show that your life and my life began at conception (although “pro-choice” dogma refers to this as ‘fertilization of an egg’- as if embryos were merely peculiar eggs rather than the earliest instance of a new human life).

    2) ‘Person’ is not a scientific term. The distinction between a ‘person’ and a ‘non-person’ is a philosophical one. There is a traditional philosophical definition of ‘personhood’ which is used in discussions of rights to autonomy, and it does exclude fetuses- however it also excludes infants, and therefore is not accepted as a basis for denying a right to life by anyone. Rather, ‘pro-choicer’ argue for their own unique philosophical definition which continues to exclude fetuses but includes infants. ‘Pro-lifers’ include both. There is nothing scientific about such a dispute.

    • crowepps

      Any legitimate biology text will show that your life and my life began at conception

      Your life and my life began at conception – it is a logic fallacy to insist that the reverse is also true. The majority of ‘conceptions’ do not result in a live infant. All concert pianists were once fertilized eggs – fertilized eggs do not all result in great piano players.

      although “pro-choice” dogma refers to this as ‘fertilization of an egg’- as if embryos were merely peculiar eggs rather than the earliest instance of a new human life).

      Fertilized eggs are zygotes, which IF THEY ARE ABLE TO DIVIDE become blastocysts which IF THEY ARE CAPABLE OF IMPLANTATION becomes an embryo which MAY if it develops correctly become a live-born infant. You might want to do a little reading up on reproduction so that the vocabulary isn’t so puzzling.

      http://www.merck.com/mmhe/sec22/ch257/ch257c.html

  • invalid-0

    I’m against both, but those who are opposed to abortion are just as entitled to call themselves ‘pro-life’ as those who favor gun control (which limits individual choice on 2nd amendment issues) or school vouchers (which increases individual choice regarding education and an ability to opt out of public schools) are to call themselves ‘pro-choice’. The labels are not arguments, they’re just names based on which value (life or choice) one prioritizes in the abortion debate. Don’t apply standards to the opposition which your movement doesn’t meet.

  • invalid-0

    Actually, I just remembered that Peter Singer (the famous animal rights ethicist) does use the traditional definition and acknowledges that because of it he finds infanticide morally acceptable. That is a ‘fringe’ position, though.

    • invalid-0

      Peter Singer is not a physician. He is a philosopher. That does not make him, per se, qualified to make that decision.

      As for the anon who is cherry picking text books — any good medical textbook refers to such as a fetus until it is born. Largely, because that is what it is.

      • invalid-0

        1. yes- that’s because “person” is a philosophical term, not a scientific one- who should define it, then?
        2. didn’t say they weren’t fetuses, read my comment. I said that all new human lives begin at that point- which is an scientific fact (you could argue that in the case of monozygotic multiples, the individual life does not- but the life from which they develop did- hence the zygote is the starting point for all ‘persons’)

  • invalid-0

    If health care and poverty are as important to you (and I) as you claim, then you’ll still support it even if HHS doesn’t have the authority to include abortion, and even if subsidized plans must exclude abortion. Then you and I and the Catholic church can all get behind it. Fair enough?

  • invalid-0

    You might like to do a little reading yourself about the definition of personhood (which is philosophical and non-scientific and excludes infants) and logic (regarding a fallacy and negation). The fact that all piano players were once zygotes is not a basis for saying that all zygotes will play the piano – OBVIOUSLY- but the fact that some zygotes die before they become what you classify as a person (a subjective judgment that is merely arbitrary given that you changed the traditional definition to suit your purposes) does have any moral implications regarding their status.

    Some babies die or get brain damage because of complications during birth. Does that mean that the possibility of natural death should imply a right for others to cause death if they see fit to do so? Obviously not, unless you think that there should be no restriction on abortion on demand up until birth (which no reasonable person wants).

    Your “logic” that if a thing could die naturally, then you are entitled to kill it is the most puzzling thing here.

  • invalid-0

    I think that we both know that ‘pro-choice’ is as spin just as much as ‘pro-life’ is. No reputable media outlet uses either term. They generally say ‘abortion rights activist’ and ‘abortion opponents’. That isn’t ideal for either side, but it is laughable to argue that ‘pro-life’ is inaccurate and ‘pro-choice’ is accurate! By your standard, the NRA isn’t ‘pro-gun’, but ‘pro-choice’!

  • invalid-0

    I don’t need a biology lesson. I know the difference between a fetus and an embryo or between a blastocyst and a blastocoel and between haploid and diploid. The point I was making is that you folks (look at the ad above and to your right about ‘eggs as persons’) are the ones who are using crazy terminology. No one is arguing for eggs to have the status of a person. Human eggs are ova. After the ovum is fertilized, it is a zygote. It is not an ovum anymore. The ads are implying that some eggs might be considered persons under the proposed laws. These laws would protect zygotes, not eggs. Maybe you folks need to go back and read up on reproduction yourselves.

  • invalid-0

    unless you think that there should be no restriction on abortion on demand up until birth (which no reasonable person wants).

    Your “logic” that if a thing could die naturally, then you are entitled to kill it is the most puzzling thing here
    [emphasis added]

    This is why I say “medical standards, not laws”. It’s better if reproductive choices are a privite decision between a woman, her doctor, and her chosen advisers). A woman isn’t going to wait until birth minus a day to demand an abortion on demand — and would need a doctor’s cooperation, anyway. When I support “in theory” abortion to the last moment, it’s because the effect of laws that disallow late abortions except for certain conditions is that the necessity of “proof” puts women more at risk. By the time a doctor, for instance, can “prove” a woman will die without an abortion she’s at great risk of dying anyway.

    In Canada, there aren’t abortion laws — the Canadian Supreme Court ruled them unconstitutional. Medical standards work in Canada — I wish that was the case here. I don’t say “no limits”, I say “medical limits — without interference from strangers”.

    • invalid-0

      If one is free to get an abortion with no limits except what a doctor will agree to… that is abortion on demand with no limits. All you’ve done is say that you need a license and then it is legal for you to provide it without limitation. The least ethical doctor becomes the standard. That is the situation which I said ‘no reasonable person’ wants.

  • invalid-0

    No one is arguing for eggs to have the status of a person.

    Well, why shouldn’t they? The egg is a lot larger than a sperm cell, you know. If an egg + sperm is a person, then an egg alone is 99% of a person, and so should be treated as basically the same thing.

    I mean, abortion-lovers seem to think that birth is such a big deal in terms of turning a fetus into a person, when obviously it’s just a small change in location. It’s like saying that I’m a person in the kitchen, but not in the bedroom! How silly is that?

    Just as silly as saying that you’re not a person until you eat this sandwich. To an egg cell, a sperm cell is like that sandwich.

    • invalid-0

      A zygote is an organism which will become an adult human unless something prevents it, just like a toddler. An egg is not.

  • crowepps

    I was addressing your entirely false assumption that because philosophically a zygote MIGHT eventually become a person that it should be considered to have all the rights of a person. The zygote is actually UNLIKELY to become a person, which doesn’t mean that anyone is “entitled to kill it” but instead that people should be able to make a CHOICE about how much of their own personal biological capital they are willing to invest in it. The difference is that you are speaking philosophically about the value of fetal life and I am speaking concretely about the real-life decision of an actual human being who has to make a decision about whether they CHOOSE TO disadvantage themselves to support someone else.

    • invalid-0

      A person should have the right to own property, the right to freedom of speech, the right to vote in elections…

      Infants aren’t persons. They don’t get those righte. They have rights which protect them from being harmed by others. Fetuses aren’t persons either, and it is arbitrary to say that they shouldn’t get those rights as well. Ethics requires a morally relevant reason to make such a distinction- not a morally convenient one.

      If you’re arguing that a fetus (because there are no abortions of zygotes) is something that someone is entitled to ‘CHOOSE to kill’ as opposed to entitled ‘to kill’, then that is a distinction without a difference. If you’re arguing that someone is entitled to choose to kill if the only other option is an undesired duty to safeguarding it, then your reasoning doesn’t work if we are talking about infants, and again there’s no non-arbitrary basis for this distinction. The fact that something MIGHT not survive, is not a justification for ensuring that it WILL NOT survive when doing so is less of burden.

      If 18% of pregnancies (which are known) end in miscarriage, and about two thirds of miscarriages occur just after implantation, then only 6% of aborted fetuses would have miscarried anyway. That means that in REAL_LIFE, your pursuit of personal autonomy for women leads to millions of deaths a year.

      You are making a philosophical claim about the value of fetal life such that even though it shares the same ‘personhood’ status as an infant, it can be treated as property: of value if valued by its possessor, but otherwise merely disposable.

      In REAL-LIFE, your ‘personhood’ argument is either inconsistent or just as much a subjective expression of value as my perspective, so don’t try to pretend that you are advocating an objective point of view when it is anything but.

    • invalid-0

      Out of curiosity- do you believe that human beings should always be allowed to make a decision about whether they CHOOSE TO disadvantage themselves to support someone else, and that their choice shouldn’t be encumbered by the law? If a person were trapped with a non-person (like an infant) on a mountaintop unable to get back to civilization until after the snow began to thaw, then would you fault the person if they chose not to cut their own rations and melt ice over a stove in order to feed and bathe the non-person? If the non-person died either because it was neglected or it was euthanized, then do you think that that is merely an acceptable result of a choice not to disadvantage one’s self?

      I suspect that you would feel (as I do) that there is no choice that one is entitled to make in such a case: there is only what one has a duty to do, and what ought to be prohibited. I wonder if I am wrong, though.

  • invalid-0

    Canada has medical standards, not laws. The “least ethical doctor” has not become the norm in Canada. I don’t make my suggestion out of thin air. It seems you don’t trust women and don’t trust doctors that trust women.

    I keep track of sites such as “Life Site” who look for and trumpet any “scandals” they can find about abortion, gay rights, etc. The only “scandals” they trumpet from Canada are protests. The bad scandals about “least ethical doctors” come from the USA — which has abortion laws.

    Why is that?

    Some of it is misrepresentation. The real scandals happen when reproductive services are protested and driven out into the fringes where a “least ethical doctor” can work outside of the supervision of his/her peers, some of them closer to back-alley than reputable doctors. Doctors who don’t want to work in the fringes and don’t want to be harrassed choose other lines of practice. To prevent the scandals, better to reintergrate legal abortion back into general OB-Gyn & general hospitals.

  • invalid-0

    If a person were trapped with a non-person (like an infant)

    Um, an infant is a person, dude. Why do you think a born infant is not a person?

    I suspect that you would feel (as I do) that there is no choice that one is entitled to make in such a case: there is only what one has a duty to do, and what ought to be prohibited. I wonder if I am wrong, though.

    Leaving the infant to die would probably not be good, although a real assessment would depend on the circumstances (e.g. was the older person chased away by a vicious bear?).

    None of which has much bearing on the abortion question, however, because then it’s a matter of control over one’s own body. No person or non-person has the prerogative to live parasitically off the body of another person, so if the pregnant woman no longer wants to be pregnant, then she is within her rights to end the pregnancy.

    • invalid-0

      What is with you people? How can you not know this? “Personhood” is not something that applies to the newborn. It is a philosophical term that is based on criteria which newborns do not meet. Maybe you’re thinking of legal ‘persons’ which are arbitrary and include anything that lawmakers want and include corporations according to US law! The argument that ‘fetuses aren’t persons, but newborn infants are’ is just a political invention of the “choice” movement, like the ‘zygotes are persons’ aregument of the pro-life movement.

  • invalid-0

    A zygote is an organism which will become an adult human unless something prevents it, just like a toddler. An egg is not.

    Uh, it takes zillions of times more energy and raw material to go from zygote to adult (or even toddler to adult) than egg to zygote. It’s like saying if I put two bricks together, then it will become a skyscraper unless something prevents it.

    Face it, a zygote and an egg really aren’t all that different. You’re just in denial about the personhood of the egg—I’ll bet you even support the murder of contraception (all those poor little eggs, snuffed out forever!). But then, I’ve come to expect as much from pro-deathers such as yourself.

    • invalid-0

      1. Use condoms to your hearts content. Pass ‘em out to 12 year olds (although some may use them as water balloons). Have a federally funded free diaphragm program for anyone who wants ‘em. I don’t give a f#@% about contraception and killing eggs or sperm any more than killing ‘active yogurt cultures’ when I have lunch.
      2. Really? Two bricks? Are you serious? A zygote becomes two cells, then four, then an embryo, fetus, infant, toddler, etc… As long as it remains alive, it organizes and grows without any external control. Do the bricks? Sure, this takes energy, and without it, it will die- so what? Same thing for a newborn, and for you and for me. Is this a concern for babies or for people who are unable to feed themselves from illness or injury. Come on now.

  • invalid-0

    If one is free to get an abortion with no limits except what a doctor will agree to… that is abortion on demand with no limits.

    Kind of like the way we already have “root canals on demand with no limits,” or “heart-bypass surgery on demand with no limits?” Why are limits so important to you? Is this a cost-control thing?

  • invalid-0

    Infants aren’t persons.

    No one is claiming infants are not persons. Most people are able to make a distinction between a zygote and an infant. You should try it some time

    • invalid-0

      The definition of ‘person’ does not include infants. Don’t believe me? Try libraries, they’re free. If you want to add infants and create your own alternate definition, then that’s your prerogative, but it’s no more justified than adding fetuses or zygotes.

  • invalid-0

    I don’t give a f#@% about contraception and killing eggs or sperm any more than killing ‘active yogurt cultures’ when I have lunch.

    Then you, sir, are a cold-hearted murderer. One day, you’ll repent and seek the Lord’s forgiveness. Until that day, I’ll pray for you.

    Really? Two bricks? Are you serious? A zygote becomes two cells, then four, then an embryo, fetus, infant, toddler, etc… As long as it remains alive, it organizes and grows without any external control.

    Okay, so there’s no problem if the woman decides to step out of the picture, then. Someone else can take care of the zygote and give it the energy it needs so that it can organize and grow on its own.

  • invalid-0

    What is with you people? How can you not know this? “Personhood” is not something that applies to the newborn. It is a philosophical term that is based on criteria which newborns do not meet.

    Ah, another member of the Peter Singer fan club. How many newborn infants have you killed [but not murdered, because that would mean that said infants are legal persons] today, sir?

  • invalid-0

    Let us completely ignore the actual work that goes into nurturing this precious little “person” from zygote to infant and beyond, and pretend that it occurs in a vacuum, something that we can regulate as much as we like, regardless of the irrational and restrictive demands on the liberties of women ambulatory incubators.

    /sarcasm off

    I’ve come to the conclusion that all this personhood-for-zygotes guff is the ultimate way of privileging the masculine over the feminine, to the point of positing that the sperm instantly creates life and makes a “person” the moment it enters the egg, and erasing the female to the point of unimportance. It completely disregards the toll it takes on the health and life of a woman to produce a live infant, birth it, and raise it. It’s about making privilege for men on the backs of women. When you consider that removing control of women’s reproductive organs from women has a domino effect on every part of a female’s life from menarche to menopause, you will see that these anti-choice strategics aren’t really about protecting “life”, it’s about protecting male hegemony by erasing women and girls from the sphere of public life.

  • dogger

    It seems to me that no one has addressed the extent to which health insurance coverage (and the lack thereof) is part of the financial motivation that pushes some women towards having an abortion. Respondents in a 2004 AGI Survey gave multiple reasons for the decision; 73% included their inability to “afford a baby now” within their list of reasons, with 23% citing that as the most important reason for the decision.

     

    In America, an expectant mother must decide whether she can afford medical care for her pregnancy, for the first 18 years of the new child’s life, and for the remaining childhood of any existing children. For women on the margins with no insurance, such concerns may border on absolute terror. In today’s economy, even those with insurance have no security that they won’t lose it before all children are grown.

     

    Many women decide that they cannot afford a new child, or that the financial risk is too great or uncertain, and terminate their pregnancies. The women of other modern countries must consider economic factors, of course, but health care cost is not one of them. They have guaranteed health insurance coverage, for their lives and the lives of their children.

     

    I don’t suggest that universal health insurance will prevent all financially motivated abortions, but for the uninsured it would eliminate a major cost factor for giving birth. For some, perhaps many, lifetime health insurance would make all of the difference in their decision.