(WOMENSENEWS)--As a physician and abortion provider, I'm sounding the alarm: Insurance coverage for abortions is dissolving under our feet.
The corrosive agent is that "Stupak on Steroids" bill we've been hearing about, introduced in late January by U.S. Rep. Christopher Smith, R-N.J.
To see what's happening, let's take a couple of steps back.
Remember U.S. Rep. Bart Stupak, D-Mich., who nearly derailed health care reform by saying no public funds could be used for abortion?
Then came the compromise: Women in insurance exchanges can buy plans that cover abortion, but they will need to write two checks--one for the rest of their insurance, one for abortion.
That means plans that cover abortion would rack up administrative and auditing costs at a time when the health law requires insurers to pare them. I see no reason for any insurer not to just drop coverage. This is burdensome enough.
Besides that, our allegedly pro-business, free market Congress artificially inflated premiums on policies that include abortion services.
Now comes this Smith bill, which turns the existing and growing pressures on abortion coverage into a death squeeze.
Under existing health law, states can already ban all abortion coverage in the insurance exchanges that start by 2014 for people who need individual policies. This has ignited anti-choice activists to pass bans in Arizona, Louisiana, Mississippi, Missouri and Tennessee. So far.
Exchanges affect only a minority of Americans. Most of us, even after 2014, still will get insurance from our employers. But already, Idaho, Kentucky, Missouri, North Dakota and Oklahoma bar abortion coverage even in regular private insurance.
Giving Hyde Permanence
Smith's bill would give permanence to the Hyde Amendment, which is renewed annually and bars federal funding of abortions. But on top of that, Smith's bill steals valuable tax deductions from employers whose plans cover abortion, as 87 percent of existing plans do. (Health insurance is the most expensive benefit that employers provide, but some or all of the cost is deductible.) For a restaurant with $240,000 in health care costs, for example, this change could cost $28,000, according to the Washington, D.C.-based National Women's Law Center.
Smith also would stop the self-employed and those with health savings accounts from claiming abortion as a medical expense.
Abortions to save a woman's life are exempted, but not an abortion to save her health or for fetal anomalies.
The original bill also presumed to judge the seriousness of different forms of rape, before GOP lawmakers began backpedaling on this element yesterday. The bill only exempted abortions linked to rape if the rape was "forcible." This stirred an outcry among women's safety advocates and rightly so. It implies the regressive idea that statutory and spousal rape are really not so serious.
The bill is called the No Taxpayer Funding for Abortion Act. Yet only in the remotest sense could private funds, paid to a private insurer, be said to involve the U.S. taxpayer.
The only sliver of taxpayer involvement in the current law is that as a medical procedure, abortion--and insurance that covers abortion--is deductible under the tax code. But in a House speech introducing the bill, Smith explained, "Abortion is not health care."
Never mind that abortion is, actually, a legal medical procedure that 1-in-3 U.S. women undergoes in her lifetime. If the government shouldn't subsidize abortion at all, why not stop maintaining roads in front of abortion clinics, too? Or halt mail delivery? (Also: Why shouldn't we spend taxpayer money on abortion? Governments routinely spend on things that not everyone supports, like wars or climate change research.)
Recalling Past Patients
I think about the patients I've seen in the last year. They include a woman freshly discharged from the hospital, referred by her obstetrician and her perinatologist when they'd exhausted all options to stop her pregnancy-related vomiting.
I see the faces of couples who'd wanted babies, until that moment during a second-trimester ultrasound when the sonographer suddenly grew quiet on seeing a fetal anomaly.
I worry about the many women who get abortions to cut their ties to abusive men.
And then there is the most common patient. Statistically, she either has children or will in the future. She knows that now is not the time.
Dr. George Tiller, the Kansas abortion provider killed in 2009, said, "Trust women. Women are morally and intellectually and spiritually capable of struggling with complex ethical issues and coming to the appropriate decision for themselves and their families."
Too many members of Congress don't think so. The bill has 173 cosponsors so far, and needs only 45 more supporters to guarantee passage and send it on to the Senate.
I wonder. Would things be different if women made up more than 17 percent of Congress?
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Dr. Junda Woo is a physician in Texas with a background in community health and abortion care.
For more information:
National Women's Law Center:
H.R. 3: No Taxpayer Funding for Abortion Act: