According to the Guttmacher Institute’s State Data Center, in Florida in 2005, approximately 847 adolescent females became pregnant in Florida every week. Of those, 264 females terminated their pregnancies each week of that same year. For those young women in Florida whose families depend upon Medicaid public insurance to cover the costs of ending an unwanted pregnancy, unless there are extreme circumstances surrounding the situation, such as rape, incest or being life-threatening to the woman, they will need to find alternate resources to cover the costs of salvaging their future. Florida is one of thirty-three (33) states in the US that permits abortions to be paid for with public funds only in those extreme situations, under the Hyde Amendment, which was first passed and implemented over thirty years ago.
Since then, the National Organization for Women (NOW) has been involved in the fight to remove what is viewed as a barrier to access to abortion services and forces women of all ages, not just minors, to either carry unwanted pregnancies to term or pursue potentially dangerous illegal abortions without proper medical oversight, simply because they are low-income. NOW has focused its attention on politicians that have targeted further restrictions in state funding for abortions, beyond the terms of the Hyde Amendment. In time for the congressional votes on the 2012 budget, NOW coordinated a protest of Senator Marco Rubio’s office in Tampa, Florida.
Rubio’s proposals to enact legislation targeting female adolescents with the Child Interstate Abortion Notification Act greatly restricts the rights of adolescents to obtain abortions across state lines and imposes great penalties for the abortion providers who may attempt to treat them.
The number of Medicaid-eligible women that have had limited choice but to give birth into circumstances under which they would have otherwise chosen termination, has increased over time. What has not been fully studied or well-publicized are the exponentially greater costs incurred by taxpayers to feed and provide medical coverage for the mother throughout the pregnancy and delivery, adding a dependent to the Medicaid rolls, when compared to the costs of exercising choice in an unwanted pregnancy for an adolescent already in need of public assistance.
States such as Florida should supplement federal funding to cover a young woman’s decision in this situation, so that she can create full opportunity to become a contributing member of her community.
Tags: abortion, funding, Hyde Amendment, Medicaid, Teen pregnancy
Social, Cultural & Behavioral Issues in PHC & Global Health 
August 14, 2011 at 12:41 pm |
I see nowhere in your blog a note of what the added expenditures would be for this. In view of the ongoing debate on entitlements and cost-containment I would like to know just how NOW and other proponents of this measure plan to pay for this extra service. Should we increase taxes on the 48% of Americans that pay them or just print more money? Debt already makes up more than 40% of GDP so what is a little bit more? I don’t mean to sound cynical, but I think there is a serious need to start making decisions with a key concept in mind–we get what we can pay for and not what future generation can pay for. In an ideal world everything would be affordable and plausible (and in an ideal world the word “abortion” would not exist), but we don’t live an ideal world. In reality, we must match expenditures to revenues and to the degree that we can’t do this we simply don’t spend. Unlike the Federal government, State government must match monetary policy to fiscal policy (i.e. state budgets must be balanced). They can’t run a deficit. This is in the short and long term a more responsible way to run things if for no other reason than it limits the financial burden that those who are born have to carry. Find the money for it and then petition the Florida State Legislature. If the money is not there then how are going to pay for this additional service? If the money can be found (and I think it is specious to argue that in the long-term money will be saved by not having to take care of the babies that would have been aborted or the support services for the mothers that are now obviated–these come from entirely different budgets so saving money in one place does not translate into savings in another) then lobby for the measure. However, if the goal is simply to garner another service without any fiscal consideration then I think the issue is not well thought out.
August 14, 2011 at 12:56 pm |
This blog highlights the important state/federal funding distinction in the decades-old debate about public financing of abortions in the U.S.; however, I question the expediency of a state-by-state campaign, at least by national organizations such as NOW, to increase abortion access for low-income women and girls. As the blog’s author notes, the Hyde Amendment, in its current form, restricts use of federal Medicaid funds for abortions to abortions sought as a result of to rape, incest, or a life-endangering condition of the mother. As shown in the blog’s Guttmacher Institute link, individual states, which have separate Medicaid funds, must use those funds to cover at least the same categories of abortions as the Hyde Amendment, but they can also go beyond those categories and cover abortions sought for other reasons.
As the blog points out, many states go no farther than the Hyde Amendment’s minimum floor. If the Hyde Amendment’s categories of coverage were expanded, or if the Hyde Amendment were repealed, there would necessarily be an expansion of state Medicaid coverage for abortions in those states, including Florida, that only meet the Hyde Amendment’s minimum requirements. Given finite (and in this economic climate, probably declining) resources for advocacy efforts, it might ultimately be more effective for organizations such as NOW to fund a campaign to either amend or repeal the Hyde Amendment. Such a nationwide campaign would also be poised to address the recurring national challenges to abortion access, such as the proposed Child Interstate Abortion Notification Act.
August 14, 2011 at 6:40 pm |
Abortion is an elective procedure. No one dies from NOT having one. There are many people on Medicaid, as well as various government funded insurance and private insurance plans that cannot receive necessary procedures and therefore suffer additional morbidity and mortality. For example, many newer cancer treatments are not available to them. It would be wrong to take money to pay for an elective procedure when people could use any extra money we have to pay for things that sustain and improve life. In addition, I don’t see abortion as a great form of birth control. Medicaid pays for many other forms of birth control that are not so controversial, such as the pill, the implant, the vaginal ring, the IUD, Plan B, and Depo shots. None of these options tend to cause psychological trauma on the would-be mother either. They are not invasive procedures that cost more money and have more potential complications. Its much more cost effective to provide Plan B (the morning after pill).
August 15, 2011 at 9:02 pm |
This is obviously a very emotionally charged topic.
A few things to consider:
The cost of providing an abortion using Medicaid funds is far less than the cost of providing hospital services for a delivery of the child that would have been aborted, regardless of the costs associated with raising the child that with which Medicaid is also involved.
Medicaid typically does not provide for the vaginal ring or Mirena.
Perhaps funding to support overturning the Hyde Amendment would be better spent on sexual education and access to birth control methods, especially given that the majority of states use the Hyde Amendment to guide their access to abortion services.
Despite what many “pro-life” campaigns espouse, rarely is abortion used as a form of birth control.
• Fifty-four percent of women who have abortions had used a contraceptive method (usually the condom or the pill) during the month they became pregnant. Among those women, 76% of pill users and 49% of condom users report having used their method inconsistently, while 13% of pill users and 14% of condom users report correct use.
• Eight percent of women who have abortions have never used a method of birth control; nonuse is greatest among those who are young, poor, black, Hispanic or less educated.
I feel these statistics underscore the need for EDUCATION of the women at-risk, the public at large, and the lawmakers contributing to the legislation governing our nation.
August 18, 2011 at 8:44 pm |
Utilization tables/patterns are actually evaluated on a routine basis by insurance plans. What they show is that covered services are not mutually exclusive. Offering one service does not mitigate utilization of another service as long as they are perceived as equally useful. Abortion services are not competing with full-term services for volume and, therefore, expenditures. Offering termination of pregnancy does not reduce the volume of deliveries a plan must cover. Each time a new service is covered it just increases the potential outlays for the insurer. The competition between services is the following: the potential patient has the service covered by the insurer vs. the patient does not have it covered by the insurer and finds other resources or means to obtain the service (i.e. out-of-pocket). This, in fact, is part of the argument that the proponents of Medicaid coverage for abortions are making (i.e. the fear that abortions will be performed regardless of not being a covered service by people not adept at the service). The actuaries at the insurance firms analyze this frequently and they know that offering another service only increases immediate outlays. A CT scan is less expensive than an MRI, but offering one does not reduce the volume of the other. The way that insurers limit outlays for services is by not covering them or requiring that you pay for a policy for a specified period of time before a service is covered (this is a notorious practice in obstetrical coverage by private insurers). Just like the line from the movie: “If you build it they will come”–if you offer the service it will be used. If abortion services are to be offered to Medicaid recipients then the expenditures must be calculated. Anything shy of this is leads us to the fiscal problems we are already facing. Erin, I do agree with you fully in the regard that “education” is the only way to tackle this issue whether we as a society support or reject abortion rights. You are completely correct in this regard.