banktime.com

I recently read a compelling argument by Nancy Folbre, a professor of economics at UMass-Amherst, on why she believes that abortion coverage should be included in the public health insurance option being debated by Congress at present. Folbre, an unabashed feminist, digs right into the gist of her argument with her assertion that the Stupak-Pitts amendment (that would prohibit companies taking part in subsidized health insurance exchanges from paying for abortions) is “stupefying.” Conservatives obviously love the concept of limiting abortion in any way, shape, or form. On the other hand, womens’ rights groups and liberals are fuming at what they call an undermining of Roe vs. Wade. Folbre obviously falls into the latter camp, but she choose to frame her argument with economics, rather than politics and opinion.

Folbre points out that neither the House bill nor Senate proposal covers contraceotive products or services, pelvic exams, or treatment for sexually transmitted infections or disease. Some Republicans have gone so far as to suggest that prenatal care should not be covered – what, because anything but zero population growth is really a choice? The GOP claims that those hyperventilating at these terms are merely over-reacting. It’s not like the proposals would not cover family planning, they claim. Any anyway, the overall expansion of medical services would clear up room in the budget of even low-income women to compensate for having to pay for birth control and abortions (if desired) out of pocket.

Folbre points out that these “minor restrictions” on abortion just keep “piling up.” One or two don’t seem like a big deal, but altogether they continue to undermine a service that is essential to women’s welfare and was determined decades ago to be perfectly legal. The infamous, thirty-year-old Hyde Amendment banned the expenditure of funds spent by Health and Human Services on abortions. Since then, this original prohibition has been expanded to health insurance covering federal employees, patients of the Indian Health Service and women in the Armed Forces. Nowadays, almost half the states in the U.S. mandate that women seeking abortion wait at least twenty-four hours after required pre-operative counseling to undergo the procedure. This is very inconvenient, especially for women living in areas where the closest clinic is a long way away. (Given that a 2005 study found that eighty-seven percent of all American counties lacked abortion providers, this isn’t all that unlikely a scenario.) Five states, all in Middle America, prohibit private insurance coverage of elective abortions altogether. Clearly, the trend is toward undercutting abortion.

Folbre believes that the Stupak-Pitts amendment would not just affect the administration of private insurance, either. She argues that the passage of such legislation “would probably move the [healthcare] industry away from current norms of coverage for medically indicated abortions.” Folbre is far from the first expert to speculate that conservatives are slowly undercutting the legality of abortion. The so-called “Laci and Connor Act” (named for Laci Petersen, victim of a horrific murder during her third trimester of pregnancy), continued restrictions on stem cell research, and aggressive public opposition to later-term terminations are all examples of factors that are cited as contributing to an overall culture of rejection towards the controversial procedure. That’s to say nothing of abortion’s place in the massive, loud contemporary healthcare debate. It’s clear to all that changes in this area are needed, but it seems increasingly unlikely that these changes will come without a sacrifice on the part of reproductive rights.

Consider the economic fallout of such a trend, she implores. If a restriction on publicly-funded abortions is enacted by the United States, many low-income women will face the difficult choice to either find the out-of-pocket money for an abortion, or continue to carry an unwanted pregnancy. Smug Republicans would claim that a prohibition on abortion coverage will keep women responsibly using contraception, since they do not have access to termination as “insurance.” But such ways of thinking do not address the very real problem of contraceptive failure, says Folbre. Nor does it seem likely to address the fact that Americans tend to suffer from an awful lot of unintended pregnancies. Appromately one-half of all conceptions, and one-third of all live childbirths are described by the parents as “unintended,” the professor cites. Folbre’s parting blow is this: if health insurance is designed to compensate for the unintended and unplanned crises in life (like getting sick, injury, etc.), then is unplanned pregnancy not the very epitome of that category? “We need insurance for a reason,” she concludes.