June 21, 2018
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Abortion care must be part of US health plan

By George A. Hill, Special to the BDN

On Nov. 7, I received one electronic message after another from national abortion rights organizations notifying me that the U.S. House of Representatives was about to pass H.R. 3962, the Affordable Health Care for America Act. That was the good news.

The bad news was that House leaders had agreed to allow a vote on an amendment introduced by anti-choice Rep. Bart Stupak, D-Mich. The Stupak Amendment proposed to ban insurance coverage for abortion in the new health insurance exchange, even if women want to pay for that coverage with their own money. This is a dramatic restriction on women’s right to access insurance coverage for abortion care, going far beyond the standard of no federal funding established over 30 years ago with the Hyde Amendment.

The amendment passed by a vote of 242-192. To her great credit, Maine’s 1st District Rep. Chellie Pingree voted against the measure. Regrettably, 2nd District Rep. Michael Michaud voted in support of it.

Now the health care reform debate moves to the Senate, where Utah Sen. Orrin Hatch has promised to introduce a similar amendment to the Senate’s health care reform bill.

Most Americans get their insurance through their employers, and for 85 percent of those Americans, that insurance covers abortion care services. They would not be affected by this bill’s abortion ban … for now. But because the bill envisions eventually allowing both small and large employers to purchase insurance through the new exchange, the number of women barred from getting insurance coverage for abortion care could grow to staggering numbers.

Nationally, the Alan Guttmacher Institute reports that 13 percent of the 1.2 million abortions among American women each year are directly billed to private insurers. Most women pay out of pocket, at least initially; an unknown number are reimbursed by their insurers after the fact.

The impact the Stupak Amendment could have on Maine women is disproportionate. In Maine, an estimated 30 percent of abortions are billed directly to private insurance, more than twice the national average. Still more women may seek reimbursement from the insurers.

Private insurance coverage for abortion care has been an article of faith for most of the last 35 years. As a result, pro-choice advocates simply have not needed to explain why any move to limit insurance coverage for this critical medical procedure should be resisted as strongly as any anti-choice decision being considered by the Supreme Court. It is clearly time for that explanation.

Simply put, abortion is health care, just as much as any other medical procedure, and must be an equal part of health care reform. One in three American women will have an abortion in her lifetime. Abortion is the second most commonly performed surgical procedure for women in the United States, second only to wisdom tooth extraction.

Eliminating private or public insurance coverage for abortion will have the inevitable effect of forcing women to scramble for the funds needed to pay for the procedure. This, in turn, will result in procedures performed later in pregnancy, making it more expensive and more complicated.

While Maine nonprofit abortion providers such as the Family Planning Association make every effort to subsidize the cost of abortion care to women who qualify, we have heard stories of uninsured women so desperate to secure funds that they have been forced to sell essential belongings — cars, furniture, beds. This is not reform.

Lack of insurance coverage also adds to the burden of families who, due to fetal anomalies or other complications, must make extremely difficult decisions about continuing a very wanted pregnancy. Without insurance, these decisions and arrangements become all the more overwhelming.

Throughout the health care reform debate, President Barack Obama’s essential promise has been that no one will lose the benefits they currently have. The Stupak amendment breaks that promise to millions of women.

We urge Mainers who believe health care reform should not be passed at the expense of women’s rights to contact Sens. Olympia Snowe and Susan Collins, encouraging them to reject any attempt to add the Stupak amendment to the Senate’s health care reform bill.

To do otherwise is a quantum leap backward to a time when women had no choice but to continue an unintended pregnancy simply because they could not afford an abortion.

George A. Hill is the president of the Family Planning Association of Maine.

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