Mention the word abortion, and everyone has an opinion. But regardless of what people think of abortion, it is legal — and has been since 1973, when the U.S. Supreme Court said it is a constitutionally protected right for a woman to make the decision with her doctor. It also is common. About one in three American women will have had an abortion by the time they are 45 years old. In 2011, about 2,360 women obtained abortions in Maine.
Yet abortions are one of the only procedures not covered by MaineCare, Maine’s health care program for low-income residents funded by Medicaid. If a woman has money, she can pay for one. If she has a good job that offers private insurance, her abortion is likely covered. But a low-income woman is treated differently, even if an abortion is recommended by her doctor to preserve her health.
The basic level of health care available to women should not differ based on how much money they earn.
The discussion about MaineCare-funded abortions comes to the forefront of public debate every so often, and it rose up again recently in the gubernatorial race. Independent Eliot Cutler and Democratic Rep. Mike Michaud (first elected to Congress as a “pro-life” candidate in 2002) both said they support allowing MaineCare to cover the cost of abortion services. Republican Gov. Paul LePage does not.
Some will argue that tax dollars should not be spent on a procedure that many find morally objectionable. But that rationale does not lead to quality policymaking. How many people need to object before a medical procedure will no longer be covered by Medicaid?
Tax dollars pay for many things residents don’t like or oppose outright. Their tax dollars fund the salaries of the politicians they don’t vote for. They fund the health care of inmates convicted of murder. They support the Department of Defense.
For several years after abortion became legal, Medicaid covered abortions without restrictions. But in 1977, Congress passed the Hyde Amendment, which banned federal funding for abortions. States can choose to cover them, however, without federal assistance.
It is unfair to withhold funding for procedures that are available to more well-off women. Low-income women often delay getting an abortion to find the money to pay for it, increasing the cost and risk of complications.
The Guttmacher Institute estimates that, in Maine, state and federal governments spend $33 million each year on births resulting from unintended pregnancies. In 2007, having MaineCare cover abortions was estimated to cost $283,000 annually. Some would argue the cost has since decreased, given that Maine’s abortion rate has decreased.
All women deserve access to good health care, and politicians shouldn’t be able to restrict their coverage because they are poor. Maine should make policy decisions based on fairness, not popularity.