Virginia Denies Medicaid Funding for Abortion in Cases of “Substantial Endangerment”


Maggie, a Class R diabetic and mother of two living in northern Virginia was devastated by the news. She was pregnant… again. Her first pregnancy resulted in complete bed rest at 16 weeks and she lost her eyesight. It took nearly a year – during which Maggie cared for both her newborn and her adopted son – for her sight to return. Doctors warned Maggie her body might not be able to endure another pregnancy; they mentioned the likelihood of a stroke, permanent blindness and other life altering ailments. After consulting with a team of medical professionals, Maggie and her husband chose to end the dangerous pregnancy. There were simply too many signs that another pregnancy would threaten Maggie’s ability to care for her children and maintain her health.

This April, Maggie’s traumatic story was shared on the floor of the Virginia General Assembly. Lawmakers shared stories of women with chronic conditions for whom pregnancy would severely jeopardize their health. They shared the stories that don’t usually make it into the public arena –the stories you only hear when a sister, a cousin, or a close friend has to face this kind of devastating choice. They were a stark reminder of a fact that’s easy to ignore: even in a country with highly developed medical technology, pregnancy is one of the most dangerous conditions a woman can face. In the end, it came down to just one vote on the Senate floor.

Nevertheless, despite hearing these accounts, 84 of the 140 members of the General Assembly revoked the previously-held right of low-income women to receive Medicaid reimbursement for an abortion if the pregnancy presents a “substantial endangerment” to their health. The reason for this change? To save the commonwealth a mere $150,000.  

This amendment is a huge set back for women in the commonwealth. Last year, 147 recipients of Medicaid received this subsidy to terminate pregnancies that would have substantially endangered their health. Going forward, these women will no longer qualify for this reimbursement, and will need to either find the funds independently or endure a dangerous pregnancy. Low-income women will bear the brunt of this callous act.

The Governor’s Office insists this amendment will save the state money, but ultimately, the Virginia taxpayers will bear a far greater cost associated with these dangerous pregnancies. The true cost to taxpayers of a Medicaid recipient’s pregnancy, particularly if she has diabetes, cancer or another degenerative illness, far surpasses the cost of termination. In 2006, the commonwealth spent $227 million caring for Medicaid recipients with diabetes – a total of 12,000 hospitalizations. We assume that difficult pregnancies would increase total hospitalizations, driving up the associated expenses. If a diabetic like Maggie could not afford to terminate her pregnancy and carried it to term, the costs associated with her pregnancy and the related complications of her disease could easily reach $150,000 in a few years… even months. In the face of even one of these scenarios, the $150,000 savings begins to look like a drop in the proverbial bucket.

In addition, the broad language of the amendment suggests its repercussions could extend far beyond Medicaid recipients. The amendment specifies that “no general or non-general funds can be used to fund abortion.” The term “non-general funds” can apply to any monies flowing through the state’s university training hospitals, such as UVA in Charlottesville, MCV in Richmond, or EVMS in Norfolk. This means that women like Maggie, who seek care at a state-supported hospital, might see their procedures refused, even if recommended by their physicians. Additionally, state employees are bookended because state-sponsored health insurance will not cover any abortion and now a state hospital will not be able to address a critical situation. Surprisingly, we have yet to hear an opinion from our illustrious Attorney General Ken Cuccinelli – who is vehemently anti-choice – regarding these concerns. Without a doubt, despite his silence, he will find every possible way to make abortions less accessible in Virginia.

Let’s be clear. This is not about money. Considering the paltry savings associated with the amendment, it’s clear this decision reflects politics and ideology, not fiscal responsibility. This is about making decisions for women and their families without their input. This is about banning abortion by making it inaccessible – one reason, one woman at a time.

However, there is a way to turn this situation around. Because the governor’s amendment was made through the budget and not the legal code, we have the opportunity to change this disastrous policy during the next budget cycle.

For the Maggies of Virginia, there is no time to waste. We must all understand the implications this amendment has for the women of Virginia. Lawmakers may not be able to ban abortion entirely –but they can make it inaccessible. And that’s exactly what they are doing right now. Women must ask the governor, their delegates and their senators, “What sacrifices are you willing to make to save $150,000?”  The women of Virginia ask you to reconsider.

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  • equalist

    We need to be as vocal as the anti choice in this kind of matter.  Instead of taking a handful of women to the lawmakers, we need to take a hundred.  Flood their inboxes and voicemail with personal stories.  Give them copies of the medical documents, and these need to be personal accounts.  “I almost died when…” is so much a stronger argument than “I had a friend who…” These are the stories they need to hear, over and over until we cannot be denied.  The anti choice side uses emotion as a means to get their points pushed through, we should use the same tool.  We need to fight harder and stronger than the religious right because quite honestly, the “pro-life” side is anything but when it comes to women’s lives and health.  If we don’t stand up to defend our own health, it’s pretty clear that no one else will.

  • claire-keyes

    Luckily, the Virginia legislature will have an opportunity to reverse their position to allow women to die rather than pay for medically necessary abortions.  Equally important, they will have the opportunity to review the financial realities in these cases.  Rather than allocate approximately $1000 per procedure, the state will pay out millions for the women, fetuses, babies medically affected by this horrible, shortsighted decision as the complications become more severe and the outcomes more dire.  In addition, families will be destroyed when the mothers die or become incapacitated, with some children being placed in foster care.  How on earth did the VA legislature think that this was a wise decision?

    @Equalist:  I hope you live in VA and can help to mobilize women as you have suggested to save women, families and taxpayers from this foolish and cruel decision.

  • rachel-larris

    What was the list/number districts of Democrats that voted for this?

  • crowepps

    H.L. Mencken’s comment here refers to the proponents of Prohibition, but I was struck by how accurate a description it is of the present generation of moralists:

    But do the Prohibitionists admit the fact frankly, and repudiate their original nonsense? They do not. On the contrary, they keep on demanding more and worse enforcement statutes — that is to say, more and worse devices for harassing and persecuting their opponents. The more obvious the failure becomes, the more shamelessly they exhibit their genuine motives. In plain words, what moves them is the psychological aberration called sadism. They lust to inflict inconvenience, discomfort, and, whenever possible, disgrace upon the persons they hate — which is to say, upon everyone who is free from their barbarous theological superstitions, and is having a better time in the world than they are. They cannot stop the use of alcohol, nor even appreciably diminish it, but they can badger and annoy everyone who seeks to use it decently, and they can fill the jails with men taken for purely artificial offences, and they can get satisfaction thereby for the Puritan yearning to browbeat and injure, to torture and terrorize, to punish and humiliate all who show any sign of being happy. And all this they can do with a safe line of policemen and judges in front of them; always they can do it without personal risk.

    http://www.britannica.com/blogs/2010/04/the-dead-hand-of-puritanism/

  • equalist

    I’m in SC, not VA.  I know we need to start at a state level, but this should be a national goal anyway.  I just wish I knew how start to put something into action to get their attention.

  • wendy-banks

    H.L. Mencken’s comment here refers to the proponents of Prohibition, but I was struck by how accurate a description it is of the present generation of moralists:

    You’re right, that quote fits VERY well.