On Saturday morning we woke up and bounced into the living room excited to watch, of all things, the House health care debate on CSPAN. It was a good spectacle at first, as women lined up on the Democratic side for unanimous consent to revise & extend their remarks, or some such parliamentary procedure thing.
It was hard to miss the messaging on the Democratic side – the idea seemed to be to get a bunch of women up to talk about how the bill would support the health of women in a variety of ways. It’s no single-payer by a long shot, but the bill will increase access to health care for a lot of people (men and women), and go a long way to helping people with treatable and preventable conditions as well as reducing medical cost-related bankruptcies.
Of course, there are plenty of people who are now saying that the bill passed the House only by selling out the health of women, or at least their reproductive freedom. And probably they’re right – that is what the bill did. The Stupak-Pitts amendment means that insurance plans receiving new federal subsidies to keep costs down (for families making less that $88,000 per year) will also not be able to cover abortions. So those plans can continue at a higher cost to their customers, or they can drop abortion coverage to be eligible to participate in the health case exchange.
The result will likely be (if the plan passes with the Stupak amendment, something that’s now questionable in the Senate) a decrease in access to abortions among middle class women. William Saletan has a good explanation over at Slate, and he asks the provocative question: If this is the cost of health care reform, are we willing to pay it?
Abortion’s been a hollow right for many, many women for a long time – at least since the passage of the Hyde Amendment, which banned federal funding for abortions and ensured that poor women would have a good chance of staying that way as long as they kept getting pregnant. Abortions are expensive, after all. Combine the financial barriers and geographic and social barriers (if you live in some states, odds are you won’t be able to get an abortion simply because the clinic will be too far away from you, and if you’re poor you might not be able to reach it anyway because of the lack of public transportation), and we’re left with a right without access for millions of American women.
This is not a reason to decrease access even further – just an observation about the long decline in reproductive freedom that we’ve been experiencing in this country ever since Roe tried to carve abortion rights, MacGyver-like, out of a handful of Amendments and some rubber cement.
There are a lot of people that want to see an end to the current bill on the grounds that it restricts access to abortion. I think there’s a lot to hate about this bill, including reduced access to abortion. But at the same time it’s worth considering whether it will do more harm than good if the bill passes. Lack of health insurance kills people. Lots of them. Others lives are ruined, sometimes forever, because of medical bankruptcies or preventable illnesses – all things that will be reduced after passage of the bill. Lack of access to abortion also ruins lives, but there are a lot more people whose lives will be improved with access to health care here than whose lives will be hurt by lack of access to abortion. And again, this bill only bans health plans for paying for abortions if they want to compete in the exchanges. Rich women who can pay for their own abortions will still be able to do so.
It would be great if the Stupak Amendment galvanized people interested in maintaining reproductive freedoms. If these rights were so easy to sell out, that’s a failure of the movement and a failure of advocates who haven’t been able to sell reproductive freedom as essential. Otherwise, there wouldn’t be so many pro-life Democrats acting as swing votes on critical health care legislation. We’ve been willing to roll far too long on rights without access, which are of course not rights at all, but privileges for the few. Just like health care. It should also be considered a matter of right in this country rather than a privilege that comes, for example, with working a certain kind of job or having a certain amount of money.
The danger is that reproductive rights will trump expanded health care access because health care is not seen as a right. This is a classic divide and conquer type strategy that the left should avoid at all costs.
The deal is objectionable, but so is the failure to expand health care.
I agree, except I don’t necessarily think that losing turf on reproductive freedom is just a failure of advocates or of the movement. It’s a battle that must be fought on so many fronts that I am not sure if pinning losses on advocates captures all the other arenas in which our country has been dropping the ball (like education, for starters.) The pro-choice movement, however, does have a tall order to fill. For instance, how do you ensure access to reproductive freedom in a society that is seriously torn over whether to protect the obscene profit margin of enormous private insurance companies or the bodily wellbeing of citizens?
You are so very correct about abortion being a hollow right for the women who are most economically and socially vunerable. Rights without access are privileges: well put, Kate. The lack of support, health care, and educational/social/occupational resources available to women (and their children) after they deliver and begin raising babies just adds injury to insult. Denying access to abortion is an effective way of trapping women and families into lower socioeconomic rungs. It just totally infuriates me at this point, but I still very much hope that health reform is passed. We need expansion of coverage. Getting distracted by the amendment sideshow pulls focus away from the larger goal of health care expansion. I’m not happy with any of the health reform bills, but I view them as a necessary springboard for continued reform.
Thanks for posting on this topic. I put a blurb about it on SEMI but haven’t had time to write anything meaningful.
As a pro-choice person who is trying to adopt a child, I have to chime in that lack of access to abortion does not necessarily lead to a life of poverty and ruin. Even in the poorest, ruralest counties there are options for women who choose adoption. Many women who don’t or can’t get abortions also don’t choose adoption for lots of reasons, but that could be changed. People like me will even pay for a woman’s medical expenses, travel, counseling, etc. I do believe that access to abortions should be available, but if pro-choice forces put as much energy into encouraging adoption that they do for abortion then this country, and my wife and I, would be better off.
Also worth noting: Only a small fraction of abortions — 13 percent by Guttmacher Institute estimates — are paid for directly by private insurance. The vast majority are paid for in cash, even by women with abortion coverage who do so out of privacy concerns.
I’m just frustrated that, after spending 15 years in the reproductive rights field, I’ve noticed two things: (1) Although (if you go by statistics, or read some of the terrible stories of womyn who have died because abortion wasn’t available to them) most people in this country are pro-choice (and at least 43% have had abortions, as of 2002, which is kept by clinic records and anecdotes), few people, over these 15 years, have seemed to comprehend how fragile legalized, safe reproductive healthcare is. (2) The U.S. is now the only non-signatory to the U.N. Convention on the Rights of the Child. That international treaty clearly indicates the right to reproductive healthcare. Why is it that womyn are always last? (It’s true–womyn have always been last: to “earn” the right to practice law, to be nominated for the Supreme Court, to be President someday, maybe, or even hold the Veep’s position).
Illinois just passed a parental notification law. The ACLU and I are actively fighting it…we’ve managed to get an injunction, but it’s scary that in a “blue” state, where we’ve managed for 15 years to stave this off, we lost sight of everything because of the budget snafu, and it slid in. I don’t want to even go into detail about what this sort of legislation will cost: the bottom line is lives. Read my law review article if you’re interested.
And don’t think this is it. Because birth control is just the next thing on the chopping block.