Friday, November 13, 2009

How to respond to pro-Stupak arguments

The following is a cross-post with ChoiceUSA.

"Why should the health care plan cover abortion if the procedure is elective?"

This is a question all choice advocates need to be prepared to address, and one I myself have gotten many times since the passage of the Stupak Amendment last weekend. Unfortunately, like many choice-related debates, there isn't a quick and simple answer readily available.

To even begin to address the issue we must first acknowledge that abortion is a part of reproductive health care. Like an IUD insertion or an annual PAP test, pregnancy termination must be included in any health care plan in order for women to be able to exercise control over their reproductive organs as they choose. If we deny the fact that abortion care is health care, we've already lost the battle.

From there we need to be ready to address the issue of an "elective" procedure as opposed to a "medically-indicated" procedure. It is in this discrepancy that antichoice factions have been allowed to gain headway with those who would normally be sympathetic to our concerns. Likening abortion to a sort of cosmetic surgery, refrains of "Why Should We Have To Pay for Something You Don't Really 'Need'" fall on reasonable ears. However, if we look to other facets of reproductive health care, or health care in general, we see that there are numerous cases where so-called "elective" procedures remain covered under any proposed health plan:
  • A woman has a small, benign ovarian cyst. There is no "medically-indicated" reason to get the cyst removed, but monthly ovulation is uncomfortable and she wants to undergo surgery to prevent further discomfort. Very few would argue that this woman's surgery should not be covered even though it would technically be an "elective" procedure, and to be sure, labor contractions are far more uncomfortable than the pain of ovulating with an ovarian cyst.

  • A 35 year old woman has some history of breast cancer in her family and chooses to begin having yearly mammograms even though medical research doesn't indicate the need for this procedure until age 40. This woman's screening procedure would be fully "elective," and yet no one is proposing amendments to restrict early preventative care to detect abnormal growths in her breasts.

  • Even procedures generally labeled as "cosmetic" are covered under many health plans and have not been attacked by legislative restrictions. Many private insurance companies offer coverage for reconstructive surgery following a mastectomy (which basically amounts to breast implants), a truly elective, non-medically indicated, very cosmetic surgery. No one is kicking up dust about breast cancer survivors obtaining new breasts on a federally-subsidized plan, nor should they.
Additionally, anyone who thinks abortion is a 100% elective, non-necessary procedure has never needed one themselves or never spoken to someone who has. Women who choose abortion do not feel as though the procedure is something they've "elected" to do; these are women who have found themselves pregnant unintentionally, and most cases feel as though abortion is their only option. This feeling arises from a number of factors: financial restrictions, relationship issues, life stage considerations, and medical concerns, to name a few. Because we simply cannot list every reason a woman might choose to terminate a pregnancy, this option must be left open, unconditional and unrestricted, for women to be able to access a complete range of health care options.

Another argument against our fight for comprehensive reproductive health care comes from folks who are generally sympathetic but believe we're kicking up too much dust over a relatively inexpensive procedure when there are people who need thousands of dollars in health coverage now. I do not wish to navigate into the murky waters of "he started it," but it was not "our side" that initially kicked up all that dust. The initial health bill proposal allowed for private insurance companies that would be receiving federal subsidy to continue covering abortion as their policies indicate; it was not until Rep. Stupak embarked on a mission to "compromise with" (read: capitulate to) antichoice congress members that we had any reason to complain whatsoever. In the initial health bill, shot down by Congress last Summer, representatives chose to delay providing much-needed health coverage to thousands, in part because of the abortion coverage private insurers would be able to continue providing.

Besides, if Congress was really out to save money and not impose an antichoice agenda over our health care options, things like abortion and contraception would be a priority. The average cost of "elective" abortion in this country remains in the $450 range, though due to financial assistance and low-cost clinic care the average amount paid tends to be in the $300s. Women can access hormonal contraception starting at $15 a month, and implantation methods average around several hundred dollars for 12 years of pregnancy prevention. Due to restrictions on public funds going towards any of these procedures and the lack of private insurance coverage of most, many women are forced to pay out of pocket for pregnancy prevention and termination. However, women in the United States can receive hospital-based maternity care from Medicaid: hospital births average around $7000 for uncomplicated vaginal delivery and between $12,000 and $16,000 for cesarean births. The government pays millions a year for pregnancy and birth costs, not to mention the subsequent costs from WIC programs and pediatric care, yet provides no funding for women who wish to avoid pregnancy or terminate an existing pregnancy. It is in these statistics that the true agenda of antichoice government agencies shines through: they would rather pay thousands for a woman to carry to term than address the moral quandary that is abortion care.

The real restrictions on abortion and contraception coverage remain inextricably attached to moral, not reasonable, qualms about what should be covered when. There are many conditions that are technically "elective" that remain covered by private insurance and government programs alike, and yet antichoice legislation continues to buck cost-saving reproductive health care to bend to an overlying agenda of control over women's bodies. The health care debate cannot continue without comprehensive health care being taken into account, no option left behind.

1 comment:

Rosa said...


When I found out I was pregnant, the time that began to change my mind about abortion, I looked into my insurance plan. No abortion coverage at all, but I paid nothing for my two hospital births and very little for pediatricians. I was not taking birth control at the time because it was expensive and we were trying to save money, plus of course at that time I thought the Pill was murder, oh my, which is precicely how I got pregnant again in the first place! Amazing they'd rather shovel over thousands of dollars than help me choose when to get pregnant. The Stupak amendment will affect so many women, it is truly sad.