Legislation to ban or restrict insurance coverage for abortion is sweeping through the states. Other than a Supreme Court case, these state bills may be more devastating to women’s access to reproductive health care than anything else. That is precisely why there is a huge national drive by Religious Right and anti-choice organizations to introduce and pass them.
By one estimate, 14.5 million women will lose the coverage they already have. That is in addition to women whose coverage for abortion is already restricted to the narrow cases of incest, rape or life endangerment: women who receive Medicaid, federal workers, the military, the American Indian health service, women in federal prisons and even Peace Corps volunteers.
Some background: the reason this is happening is anti-choice state legislators and governors are introducing bills or amendments to ban or limit coverage of abortion on the state insurance exchanges, which are in effect marketplaces. State insurance exchanges do not exist at this time. Most states are setting them up as a part of health care reform legislation (the Affordable Care Act) and they will go into effect in 2014. Many people who are underinsured or non-insured or want to change insurers will purchase insurance on the exchanges. So whatever happens to an exchange will affect many people.
By federal law, states do not have to offer coverage for abortion. That’s where opponents of comprehensive health care have found an opportunity to do even more damage to women’s health coverage. Five states have already passed bills to limit or ban insurance coverage of abortion, according to the National Conference of State Legislatures. Twenty-two more are considering bills. Just yesterday (3/31/11), Gov. Robert McDonnell of Virginia added an amendment to a bill setting up an insurance exchange in Virginia that will forbid coverage for abortion except in the very limited cases of rape, incest, and danger to the life of the woman. That amendment is actually telling women what coverage they can buy with their own insurance dolalrs and telling insurers what services they can cover!
This is a dangerous situation – but it also offers a chance to explain why access to abortion is so critical to women’s lives. As I wrote on Religion Dispatches:
Narrow attacks on abortion, whether from the Catholic or Protestant right, ignore the full range of issues that are involved in an unintentional pregnancy, including poverty, discrimination, abuse and violence, lack of jobs and health care, and – underlying it all – the effects of racism and sexism. They ignore the serious health issues that can affect a pregnancy and a woman’s life. They ignore the realities of young women and men who have no information or inaccurate information about sexuality, poor role models, and limited options for the future. They target abortion rather than the conditions that lead to unintended pregnancies.
We want to change that mindset. While opponents of comprehensive reproductive health care want to control women’s decision-making, we talk about the importance of options and resources in the lives of women, families and communities. While they demand “no taxpayer funding for abortion,” we explain that ample funding restrictions are already in place. While they stigmatize women who seek to end a pregnancy, we assert that abortion is an integral part of comprehensive reproductive health care and that one in three women will have an abortion procedure at some point in her life. While they demean women who choose abortion, we make it clear that forcing women to continue an unwanted pregnancy is wrong. While they rail against abortion, we elevate the discussion to consider the moral complexities of decisions about bearing children.
Insurance coverage for pregnancy termination has had a low profile until now because it was not threatened. Now that it is, it is critical to understand that insurance helps to guarantee access to reproductive health care services and – from a moral perspective – enables a woman to make a decision about childbearing according to her conscience, not what the government says is acceptable.
Progress in expanding health care coverage to millions of Americans and doing away with injustices in the system is long overdue and should be celebrated. But victory at the expense of women’s comprehensive reproductive health care is no victory at all.