The New Scarlet Letter -- A is for Abortion

Many bloggers have explained what the Stupak-Pitts amendment to the House health reform bill could mean for abortion rights in this country. Women in Congress are assuring us that this amendment will not survive the Senate bill, and we trust that they are correct. But as a mother and grandmother of a daughter, daughter in law and a granddaughter, this means more to me than just statistics. This takes me back to the days when abortion was not legal and the shame of an abortion was very much like wearing a big red letter A on your forehead.

It is bad enough that poor women in this country cannot get federal funding for the choices they must make when they become pregnant and cannot sustain the pregnancy. The cost of an abortion can range from $300 to $900 in the first trimester and up to $18.000 in the second trimester. Even middle class women would find this overwhelming. It's not just the cost of abortions that is at issue, however.

The stupid Stupak amendment would do more than reinforce the current prohibitions under the Hyde Amendment -- it could make the Hyde Amendment permanent without any opportunity to ever offer abortion coverage to poor women in this country. But it would do more than just embed abortion prohibitions more strongly in future law -- it would extend its tentacles into the lives of women who do not rely on public funding now or in the future.

Jessica Arons explains the details of this amendment well in her Huffington Post piece today. But what has not been made very clear is how such an amendment would actually work in a newly reformed health system.

There is a lot of dispute about how the Stupak prohibitions would be implemented within the Exchange. Health plans -- private OR public -- that receive federal subsidy money (and the money does go to the plan not the individual) would not be able to offer abortion coverage. How that would be sorted out is where the big A comes in -- The most likely and practical outcome would be for all plans to simply drop abortion coverage, which would force women to buy some sort of "abortion rider" to get the coverage they expect or even used to have. That is highly impractical as well. Who plans on having an abortion when they sign up for insurance coverage? And what is the stigma attached to someone who does decide they want the coverage? Are you in Plan A (for abortion) or not? (See this article in Kaiser Health News for some good Q and A on how this might actually work in practice.)

For purely economic reasons, the cost to the health plan of an abortion rider would be close to zero, since the cost of most abortions is much cheaper than a pregnancy. However, the administrative costs of offering riders is not zero. That is one of the reasons why most insurance plans in America currently offer abortion coverage, even if they don't advertise it. It just makes economic sense to include both contraceptive coverage and abortion coverage for women of childbearing age. In those states that do offer abortion riders, insurance companies do not seem to want to offer them, so they are a phantom alternative.

But this segregation of women -- into those seeking abortion coverage and those who do not -- is akin to nothing else I can think of. Do we have any other legal medical condition that would require that? Would men who might get prostate cancer have to buy a prostate cancer rider or be told their legal condition is not accessible to them?I realize pregnancy is a unique condition, but abortion is still legal, so making it even more difficult to get seems punitive, at best. And it will be very hard to administer this amendment.

It's pretty clear that the Catholic bishops and those C street guys who wrote and sponsored this amendment didn't really talk to the insurance industry, because I'm quite sure they would have been told how difficult this would be to implement.

It will not be simple to figure out how to separate out federal money in an Exchange. But if we don't want to take that step backward of wearing the new scarlet letter, we had better get busy. We need to make our voices heard to those in the Senate who are going to have to figure this out.

Here's one very postive way we can make our voices heard. Support the Congress members who voted no on Stupak. Check out this website: http://www.actblue.com/page/wevegotyourback

 

Comments

[1will]

We have about a million abortions per year in America. It is evidently affordable enough that women can get them if needed.
Obviously everthing is not going to be covered by the Healthcare Reform. Drop abortion coverage and get the Bill passed.
Women will still be able to get aborions they'll just have to pay for it. No one guarenteed a free ride for all outpatient elective procedures.

[HPdevotee]

Seriously, your apparent lack of concern over women's health care is appalling.

But here's my point...read the article! The Stupak Amnd. goes further than the status quo. It actually takes away rights and access to abortion care as it exists today. This repugnant amnd. would/could restrict ANY insurance policy in the exchange from offering abortion services and care. Currently, a majority of policies offer this coverage.

Pro-choicers are not fooled by this power-grab and attempt to backdoor Roe...it's long been a tactic of the anti-choicers that if they can't force a reversal of Roe through legit means (ie, the courts) they will try to restrict abortion so severely that it practically nullifies the right altogether.

[robbyJ]

Thank you for the info.

I didn't understand what all the concern was over the stupak amendment until your post.

Fanned

[wendellb67]

If we are going to restrict reproductive rights because some Americans don't want their tax dollars to pay for abortion, then I say I don't want my tax dollars paying for war. Let's have a line-item income tax!

[1will]

The "Reproductive Rights" are not restricted by not including abortion in the Bill. Women can still get abortions just as they do now. They would just have to pay for it.....just as they do now.

[Jonny38103]

This is just the same old crap from people who don't believe in freedom. If you don't want an abortion, don't get one. Stop telling other people how to live their lives. No American gets to decide directly how their taxes will be spent.

[JackHandsomeTheBrilliant]

The scarlet A actually stands for atheism. It's part of the OUT campaign. We call dibs.

[BevfromNYC]

Here is a question: What do women do now? As far as I know, no insurance pays for abortion on demand. Is Planned Parenthood suddenly going to close up shop?

Also I quote you - "Who plans on having an abortion when they sign up for insurance coverage?"
By it's very definition, insurance is for the unplanned event. Who plans to break a leg? Who plans to have brain tumor? Insurance is for the unexpected.

[mamalisa38]

Haven't they been screaming all summer long that they don't want the government betweet the patient and their doctor?

Bunch of hypocrites.

[Melanie Robbins]

Linda, Great article. I have an example of coverage for a bona fide, legal medical condition that is not covered generally and that one must segregate oneself into a separate group and beg for: Infertility. Infertility has long been recognized as a disease that impacts a major life function, thus making the infertile disabled. I know that will blow some minds, but this is true. However, due to the same repressive mindsets and hateful stigmatization of infertile people that is directed at the women who seek abortions, insurance companies do not have to pay for coverage for this medical condition except in the few states that require coverage. Infertile people are forced to live like Christian Scientists as a result. Thanks for your excellent reporting on the Stupak-Pitts amendment.

[Bethab]

When I was a public school teacher, my birth control was not covered by my employer health insurance but a fellow teachers infertility treatments were, even though they were far more expensive. It seemed that the public schools wanted to support procreation and discourage the choice not to have children. I don't understand why all women's health needs aren't treated the same way by insurance.

[ARTIST50]

Pro-Choice does not mean pro-abortion. I am a democrat and I don't want the government telling women what they can and can't do with their bodies: however, I think there should only be abortions in cases of incest, rape and life of the mother. I think many people don't understand that distinction. I think there should be a stigma to having an abortion for birth control. Have you seen a 3-D untrasound? Have you experienced a child in your womb moving? I know in my heart this is wrong. What we need is education to stop the number of abortions - not government. I think this issue will sink health care and IMO there are far more people that feel the way I do than you.

[T D Goggin]

I have a little trouble with the whole "rape, incest, life of the mother" thing. I haven't seen much by way of people looking to make those instances illegal. The concept always seems to get dragged into the discussion only by people arguing for abortion. What I do understand is, that as a man many women don't think I should even think about the issue. The flawed logic there involves other issues as well. Can I tell women to shut up when the topic of the draft comes up, after all women cannot be drafted? The reality is that the two sides will not ever come together on the issue.

[mamalisa38]

Men can't be drafted either because there isn't one.

[HPdevotee]

As for your "telling women to shut-up on the draft".... The difference here is that a woman's husband, son, father, brother are actualized human beings who's draft will impact her life.

In pregnancy a female assumes 100% of the physical risk (up to death) and must thus control 100% of the decision. Just as a woman has no legal right to decide men's medical care (even if she has had sex with the male) women enjoy the same control and will fight to keep it.

As for the two sides ever meeting...I agree. So, it would seem that the best course all of us could take then would be to do all we could to reduce the need for abortions..through education, availability of contraceptives and in keeping women's health care needs a priority.

[jan4insight]

Lost you on your second sentence.

[ARTIST50]

I was trying to say that I'm pro-choice but anti-abortion. I think a lot of people feel the same way. I believe abortion is wrong but I don't want the government telling women what to do. The choice should still be up to the individual woman.

I think as a man you have a right to voice your opinion and I understand how difficult it must be when a father doesn't want the mother to abort. However, ultimately it is the woman's body and I don't think any man has the right to tell here what she can do with it.

[Jonny38103]

That's all good that you have made a decision about what to do in your life. Why do you insist on trying to tell other people what to do with their lives? Freedom in America, check it out.

[aliceautumn]

Often after a baby dies in utero a D and C must be performed to insure future fertilty and the life and health of the woman. Is this no longer going to be covered either? Should we let them bleed to death or die form infection if they cant afford the procedure? Gee, every day we get closer and closer to Sharia Laws in this country.

[biggduude]

This is all politics. Despite 30-plus years of Roe v. Wade, Americans remain very ambivalent about abortion. Congress' treatment of it reflects that ambivalence. Many members of Congress come from places where the majorities are "pro-life."

http://www.gallup.com/poll/118399/more-americans-pro-life-than-pro-choice-first-time.aspx

[TXfemmom]

The same people who are so pro-life on abortion are the ones who are fighting the reforms which would provide for support of continued life and health because of being able to access health care. That just proves that they don't value life, they just claim to value it. In reality, they just hate women having a choice.

[-0013]

What about the baby's choice?

[mydwyf]

Did the baby have a choice about being conceived in the first place ?
Maybe it would prefer not manifesting in physicality in this spacetime . . .

[Jonny38103]

Go ahead, ask it. If there's no response, we'll allow the mother to decide.

[Gimlet29]

Maybe you should question your own convictions on this issue. You point to Stupek but his convictions were greater than yours on this issue. He stood up you sat down.

[T D Goggin]

If you still think it's about "choice" your being foolish. The abortion issue is about the perception of right and wrong. Some people think it's ok and some don't. No adult is going to change their mind on this issue. Nothing is wrong with feeling a level of personal shame about having one, not to mention feeling foolish about having unprotected sex. With HIV being one of the largest health issues for women you would think there would be a little more talk about protecting yourself. I agree the pill should be free, but why is it that we cannot ask for a little personal responsibility too.

[Linda Bergthold - Huffpost Blogger]

Abortion is legal. There are restrictions on it, of course, but it is a legal treatment in this country.

[jinsei]

Thank you Linda. I enjoyed your article very much :)

[T D Goggin]

It is legal, but there are other things that are also legal that cause a high level of debate as well. We as a country, executed a man last night and their are many who find that troubling. If we look at in such a way as; we feel shame for having legal capital punishment, can we not feel shame for having legal abortion?

[nicole44]

Just because you can, doesnt mean you should.

[LiberalEastTexan]

"And what is the stigma attached to someone who does decide they want the coverage? Are you in Plan A (for abortion) or not?"

Under what circumstances would that come up in conversation?

Bob: Hey Sally, did you get the abortion rider on the company health insurance?

Sally: That's none of your business, Bob. Now get out of my office or I'll report you to HR for creating a hostile work environment.

I don't really see that conversation happening...

[Suzanne525]

When you fill out the insurance paperwork, someone in your office reviews it before it goes to the insurance company.

Maybe they are supposed to be discreet, but some of the HR people I've known are the worst gossips.

[OnTheCusp]

Right there with you, Boomer. You, whose voice will surely be heard over mine.
Why do people hate women and girls so much? Why? What have we done to deserve this?
As if we aren't ALL born from a woman......

[XRaraavis]

Not ALL of us are born from a woman. Over a million and a half people a year do not get the privilege of being BORN from a woman because they are destroyed in the womb.

[grooveygrover]

it isn't a "person" until it can live and function outside the womb

[saveal]

It is the "nature" of being a woman. We all plod the path to what we do and do not deserve.

[C Pollard]

It's simple. Pelosi didn't have the votes. There are more Pro-Life members of Congress than Pro-Choice. Had abortion stayed as written the bill would have failed. Why is that so hard to understand?