The Bigger Picture: The Politics of Health Reform, Medicaid, and Access to Abortion

In the article below, the
National Network of Abortion Funds responds to
Susan Cohen’s article addressing the  potential impact of health care reform on the national abortion rate, "Politics Distorts Facts on Impact of Abortion Coverage." 

Anti-abortion forces are trying
to use the debate over health care reform to reinforce unjust bans on
abortion funding for poor women – and they hope to extend the denial
of coverage to millions of additional women.   

Even though a majority of voters
in a recent poll supported abortion coverage in health care reform,
abortion foes are working night and day to convince Congress to ban
abortion from health care reform.  (See national poll by the Mellman
Group, June 25, 2009.) 

One of the tactics on the anti-abortion
side is misuse of statistics.  For example, abortion opponents
claim that increased coverage through health care reform would send
the abortion rate skyrocketing.  They misinterpret data from the
Guttmacher Institute to make this point.  On Wednesday, in response
to such concerns, Guttmacher released a statement about the Hyde Amendment,
the law that bans federal Medicaid coverage of abortion. Guttmacher
notes that statistics on the impact of the Hyde Amendment cannot be
extrapolated to the health care reform debate.  They also confirm
that they do not expect to see a substantial rise in the abortion rate
if Hyde is repealed.  

The National Network of Abortion
Funds (the Network) agrees with these points and appreciates Guttmacher’s
ongoing efforts to document the effect of the Hyde Amendment and to
work for its repeal.  We would
like to take this opportunity to fill in
details about the damaging reach of the Hyde Amendment and what it means
in women’s daily lives, as well as to reiterate a larger vision for
real reproductive health care for low-income women. 

As Guttmacher notes, one in
four women on Medicaid who would have an abortion if it were covered
are instead compelled to continue the pregnancy.  Painful as this
figure is, it is only a small piece of the impact of the Hyde Amendment. 
Many more women are harmed by its discriminatory reach every year. 
The tens of thousands of poor women on Medicaid who do manage
to obtain abortions despite the Hyde ban on Medicaid coverage do so
at enormous cost.  At the Network, we talk to women every day who
are sacrificing food and clothing for themselves and their families. 
In many cases, women have sold their cars or are living without electricity. 
Too often, they need to use their rent money to cover abortion care
and end up homeless.  Like so many other people who are devastated
by the cost of health care in the U.S., they and their families are
impoverished by the denial of coverage.  

In addition, Guttmacher’s
figures account only for those women enrolled in Medicaid at the time
they seek an abortion, not the many more who do not enroll because
Medicaid does not provide abortion coverage.  These women, too,
are negatively affected by the Hyde Amendment.  Finally, as Guttmacher
explains, if there is an expansion in Medicaid eligibility under health
care reform, many thousands more women – we don’t know the exact
numbers yet – will be denied abortion care because of the Hyde Amendment. 
Because of racial inequalities in the U.S., these low-income women will
be disproportionately women of color. 

Health care reform was supposed
to be about expanding care, not about expanding inequality. 
Yet, the Obama Administration and the Democratically-controlled Congress
are poised to preside over the largest
cutback in reproductive health care for poor women and women of color
in decades. Clearly, advocates face a stiff uphill fight to advance
a health reform package that truly meets the needs of women and families.
Let’s face the facts: this plan won’t be the one that pleases religious
conservatives who believe they can dictate what kind of health care
women receive.  It isn’t likely to be the one that continues
lining the pockets of health insurance companies and the pharmaceutical
industry. The plan we all need should, at minimum, contain a strong
public option, provide coverage to all people in the U.S., and cover
basic health care, including the full spectrum of reproductive
health care. 

Finally, on the question of
abortion rates, while the anti-abortion groups continue to mislead,
the real call to action is clear: we need to stop the denial of care
and the imposition of great hardship on so many women and families. 

The National Network of Abortion
Funds helped over 20,000 low-income women to pay for abortion care last
year.  The Network also leads the Hyde: 30 Years Is Enough Campaign

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  • invalid-0

    Polling has consistently shown strong opposition to using public funding for abortion. I’m not convinced that the Mellman poll is accurate. Look at the way the questions have been composed:

    “Who should determine what services and treatments should be covered by insurance offered through a national health care reform plan?”

    People hearing this question may not even think of the issues being brought up here.

    “If this reform were adopted, would you favor or oppose requiring healthcare plans to cover women’s reproductive health services?”

    “How would you feel about your Member of Congress if they voted for a national healthcare reform plan that covers comprehensive reproductive health services?”

    These questions use the term ‘reproductive health services’ rather than ‘abortion’, which is not particularly helpful if you are looking for accurate results.

    The in depth question is as follows:

    “Do you prefer the view of Jones or Smith?”

    “Jones says health care—not politics—should drive decisions about what is included in a health care reform plan. There are many medical reasons why women need abortions, including high-risk pregnancies that endanger the mother’s life and miscarriages. Only women and their doctors should make these difficult medical decisions, not Congress. Politicians should not play politics with women’s health by singling out abortion in an otherwise comprehensive health care reform plan.”

    “Smith says while improving women’s health is important, our money should not go to funding abortions, contraception, and other elective procedures that are not medically-necessary. Women may have the legal right to terminate a pregnancy, but a national health plan should not cover optional procedures that many Americans find
    morally objectionable.”

    This is a false dichotomy. It implies that Jones and Smith disagree about providing abortions if a woman’s life is in danger. Given that the Hyde amendment had ‘hard case’ exceptions (mother’s life, rape & incest), it is unlikely that such exceptions would not be included in a pro-life amendment to the health care bill. Also, Smith is presented as opposing contraception, which is not really at issue.

  • clydweb

    Great piece Stephanie! We need to push for what we want, not what the religious right will ‘let’ us have!

    Great work!

  • invalid-0

    These women, too, are negatively affected by the Hyde Amendment. Finally, as Guttmacher explains, if there is an expansion in Medicaid eligibility under health care reform, many thousands more women – we don’t know the exact numbers yet

  • george

    What offends me the most in your sterile argument is the assumption that women in poverty need health care for abortions as if this new life in the womb is some kind of disease. You can look at all the polls you want but the reality is that most Americans are unwilling to fund any type of abortion. First and foremost, it is not a health concern for the mother (except in very rare situations). A handful of doctors I have discussed this with say that allowing abortions to protect the life of a mother is a joke.
    Most people are against the national funding of abortion for one main reason… it is morally wrong. online casino

    • invalid-0

      I don’t want to go as far as George in terms of mother’s life-saving abortions, but it is reasonable for everyone except extremists to admit that ordinary abortions are elective procedures for the purpose of improving the woman’s quality of life. Access to those procedures is legally protected, but procuring the procedure absolutely is not.

    • invalid-0

      PS: Access means that you are not prohibited from procuring something- not that it will be provided (although the two terms are conflated at times here).

    • invalid-0

      PS: Access means that you are not prohibited from procuring something- not that it will be provided (although the two terms are conflated at times here).