Alicia PhD

Alicia PhD
Location
New Hampshire, United States
Birthday
September 08
Bio
Alicia has a PhD in Experimental Pathology and, after having worked in a genetics lab for her dissertation, now edits scientific manuscripts full-time from the comfort of the White Mountains. Alicia is also a writer, contributing health commentary and articles on disease and anatomy to many online publishers. She upkeeps a number of blogs devoted to her interests in public health and science.

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NOVEMBER 8, 2009 6:52PM

The Stupak Effect on Women's Health

Rate: 12 Flag

 

Pregnant woman

 

Last night, the House of Representatives of the U.S. Congress passed their health care bill. 220 representatives, including 1 Republican (Cao of Louisiana), decided that the bill they had before them was what they wanted to contribute to health care reform in this country. The vote was made after a long day of debate (if you can call it that - by the evening it was a lot of Boehner lying about what was in the Reublican alternative and showing off his purty graph and Cantor talking like Mr. Bottomtooth from Family Guy) and three other votes - one for the Republican alternative, one for postponing the main vote (one final attempt by Republicans at drawing out the debate since the "where on the desk are the copies? can you come show me? I don't think I got a copy of the amendment" didn't work - yes, a rep actually stood up and did this), and then a vote for a compromised amendment brought up by Stupak of Michigan.

The Democrat introduced an amendment to prevent federal funds from going to abortion procedures. It has been explained as being a compromise for pro-life Democrats in order to ensure passage of the underlying bill. Many women are not happy about the amendment passing, and I have to admit that I feel it was entirely unnecessary and a bit of a dig at women, reminding us that in this land of freedom, the uterus is still under state control. But what is the actual impact of this amendment?

Well, first of all, the House bill isn't the final word on health care reform. the Senate still has yet to pass their version and then they have to come up with a compromise version that both will agree on. Second, there are already laws about federal funding of abortion, with exceptions. It still doesn't make it ok though - it's a legal procedure, so it should be treated equal to other procedures. If Medicare can cover Viagra for a guy, why can't a woman on a goverment paid plan make reproductive choices, too? A legal, and necessary in many ways, procedure or medication should not be stigmatized by the bureacracy. 

The most obvious Stupak effect will be that women receiving federal subsidies for health insurance (if such a program is instituted) will not be able to purchase an insurance plan that includes abortion coverage, limiting what women receiving subsidies can purchase. Sure, they can buy an additional rider with their own funds, but the women most at need for federal subsidies will be the poor, the same subpopulation with the greatest need for prenatal care and potentially the one most affected by the lack of abortion coverage. Whether you agree with abortion or not, you have to admit that there are many poor women who simply cannot afford another child, or who are involved with drugs, physical abuse, and other maladies that would prevent a successful pregnancy (successful defined as a healthy, or even live, child being born). Will we begin to see the back alley and cheap abortions increase among the poor? Not likely since federal funding for abortions is already not allowed.

So although I think the Stupak amendment was an unnecessary dig at women's reproductive rights, I'm not so sure it will have a tangible effect on health care and where federal funds go. Sure, it makes the pro-lifers feel better, and it provides a semblance of stigma to a legal medical procedure, but the care will still be available. Only time will tell if health insurance providers benefit and women suffer from women being limited in their choices.

By the way, the argument that women can just purchase an additional rider is such insane nonsense. Abortions can't be planned for - it is a medical procedure for unplanned circumstances. So any woman purchasing a rider is just putting money into the pockets of an insurance company to protect against unforeseeable circumstances. The procedure (if performed chemically, i.e. with a two pill protocol) is only $300-500 anyway, so the coverage would likely cost more than it covers. And the concept is not helpful to the majority of women who seek abortions, the poor, but that was probably the point of  the amendment - not fiscal responsibility, but to ensure that abortions are not obtained by those who need them. A judgment call by those who are not actually faced by the choice. 

If you want to know how your representative voted, the roll call is here.

Legal abortion statistics are published by the Guttmacher Institute and annually by the CDC

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Rated for thinking it through.
A rider won't work because abortion is an elective procedure and unwanted pregnancy is strongly correlated with the habits of the woman. (Yes, the most diligent of birth control users sometimes get pregnant, but the less-than-diligent get pregnant a lot more often)

The risk factors of the woman and whether she'd choose an abortion are known by her, not the insurance company. Few women who conscientiously prevent pregnancy or who would not choose an abortion would pay for the additional coverage, leaving the insurance company paying for a large percentage of the covered, hence requiring a price not worth the benefit.
This is what it takes to get healthcare reform passed. So be it. It does, however, appear to be "discriminatory" since women with limited finances are excluded from a legal and medically sound procedure. There will be a challenge in the courts one day to determine whether or not it is, indeed, discriminatory. Too many "inconsistencies", ie, mandates for individual coverage, restrictions in purchase options, and exclusion of med-surgical procedures that are legal. We shall see.
I also believe that, with all the "arguments" in opposition to any kind of healthcare reform that are based on "government intrusion and government controlling peoples' lives and government forcing people to purchase health insurance", this amendment that forces the ideological, religious, moral, philosophical beliefs of some onto all, is a perfect example of what the opponents have been railing about. It is legislating morality, as identified by some but not by all. I am a retired RN who works as needed for a Childrens' Emergency Shelter for abused, neglected children with medical needs who reside there until reunited with parent(s), adopted out, or placed into long term foster care. Virtually all of these children have been born of substance addicted mothers with many long term problems in cognitive and motor development; some have come to us after months in an ICU on ventilators after having been beaten and thrown about by "boyfriends". These mothers, who are habitually impregnated while deep into this disease process, would give no more intellectual thought to an abortion than they are able to give to becoming pregnant. My solution, especially in light of this Amendment forbidding federal funds for abortion, is to impose state mandated and funded sterilization after the second child is born of an addicted mother. Yes, the man doing the impregnation is without consequences because he more often than not, skips off into oblivion after the deed or before he can be apprehended and incarcerated. But, it needs to stop somehow.
In the vast majority of cases, isn't abortion an elective surgery? I don't think Medicare should provide Viagra, abortions, or plastic surgery, not because I think any of these procedures are morally wrong, but because you can live (and live well) without it.

So I have no problem with the health package, if only they would eliminate the viagra subsidy.
To Congressman Stupak and his lunatic followers, What legislation will you now put forward dealing with un-wanted and un-planned pregnancies, understanding that currently in the US, 1 in 5 young girls gets pregnant before the age of 19; abstinence only? And we're opposed to the Taliban for their abuse of women's rights? What lunacy!!!!!
It seems rather contradictory to me....one of the biggest complaints was "government control of our health care"....and now, in order to get the bill passed, is a special amendment to further government control of women's choices.
The other part about this that is contradictory is cost containment. The cost of an abortion for a woman who cannot afford it is far less than 18 years of federal and state assistance for an unwanted child.
This is so hard to read...I feel the top of my head steaming up. I have now lived long enough to see the curve go from abortion being illegal to abortion continuting to be a political football. And for those of you who think this is minor in the long run, I beg to differ. As a young nurse and mother in the days before Roe v Wade I was working a pediatric unit where we had lots of kids with measles etc. my husband and I were trying to get pregnant again, then pull the plug. One of the babies arrested and without thinking I bent down and began CPR. After we were finished, one of the residents, a friend, said:Girl I hope you're not pregnant because if so I"d go get an abortion becauses your baby is sure to haveone of these birth defects after this." I just stared dumbfounded at him realizing I had not even stopped to think about that. I just stuttered what he already knew: But---I-- can't get one legally.
He Said: Sure you can...make application to the ____committee for an abortion and we'll all testify for you that you weren't and still aren't quite in your right mind. (one of the few medical grounds for abortion in those late 1960 days)
Writing this I just feel my gut roil at the memory of it. Needless to say I was one happy young woman when my menses finally began TWO WEEKS LATE!! Want to even think what mental agony I actually was in?
So I'm sorry guys, I think it is diffucult for you to appreciate how tough this is. Interestingly enough, there is a rider I'd like to see attached to the bill. That every guy involved in creating a pregnancy is held accountable for child support; cannot get student loans if he does not provide child support; cannot get a mortgage if he does not pay child support. Tough? So is no choice over your uterus!
Thanks for your thoughtful article! My take is also on Open Salon (I'm a former NARAL organizer, so I have a pretty strong sense of disappointment obviously!)

http://open.salon.com/blog/rguillory/2009/11/08/representative_cao_is_not_a_hero_1
Patie.... while I'm with you in decrying this foul amendment, I think it a bit of an assumption on your part to insinuate that the mother is, or should always be, the parent awarded custody, and therefore, child support from the male in the equation. Equality means equality. Once the infant leaves the necessary physical support of the female's womb the gender of parent becomes moot.
thanks for this blog. i too am hopeful that it is no real change from the existing ban on federal dollars for abortions. that ban is certainly unjust, but it is not necessarily a bad idea to keep that issue as separate as possible from then present issue about insurance reform. at least then these pro-life dems have a fig-leaf to cover their support.
Another angle to consider:

Jehovah's Witnesses oppose a legal procedure (blood transfusions) on supposedly moral grounds. JW suddenly succeed in making blood transfusions--still a legal procedure--unobtainable by the rest of society who needs them (and Keith Richards, who just wants to be a vampire). They succeed. What would be the politics of that? Sound ridiculous? Substitute the word "abortion" for "blood transfusion." The right-wing nightmare of girls who just want to have abortions for fun don't actually exist, so there's unfortunately no substitution in this equation for Keith Richards.
Great question. This is very concerning. The point about creating a stigma around the procedure is well taken. Congress has a history of doing this sort of thing with legislation that can't be defeated. They create a stigma that attaches to it in a certain way so as to control its use. This was done with social security and welfare decades ago. This one bears close watching. Thanks for this post.
"Whether you agree with abortion or not, you have to admit that there are many poor women who simply cannot afford another child, or who are involved with drugs, physical abuse, and other maladies that would prevent a successful pregnancy (successful defined as a healthy, or even live, child being born)."

These are the very people that the right wing is trying to attack. They want them to be punished for all these things, and they think that a lifetime of poverty raising a bastard child on the street with no help from the government is perfect punishment.

Or even better, since abortion is safer than pregnancy, some of these women will die. Women having sex? A capital offense!

The reason men are never mentioned in these arguments is that they aren't a part of the rhetorical equation. The right wing sees pregnancy as a woman's fault. Can't afford birth control? No way, she should have kept her legs together. Men have the right to unlimited sex, and lazy, wanton women are to blame for tempting them.

The only time you see men brought up is to make use of the "irresponsible black fathers" meme. The assumption behind the whole argument is that making it impossible for women to have abortions will result in more of them being punished for their sins.
Boner is a total waste of good oxygen.

Impeach or recall Stupak.

Stupak should not be allowed to call himself a Democrat.

Anyone who votes against a bill that would help the uninsured should be held up as a traitor to this country as this would be a vote for the death of men, women, and children in this country.
Well, the abortion lobby has nowhere else to go. No,I don't want to pay for anyone's abortions, Viagra, cosmetic surgery, or for that matter mental health, which is an open-ended drain on resources. We may have made a mistake in traditionally excluding dental procedures, since so many cardiovascular events stem from dental problems. Hurrah for Stupak and you guys and gals in the Senate just hold your noses and vote for it.
I learn today that this Amendment prohibits healthcare coverage for abortion from ANY insurance option purchased by a woman, not just one subsidized with federal monies. Surely, there is legal basis to challenge this in a court of law. If that is, indeed, the case, women should boycott purchasing ANY new healthcare option and ignore the mandate and ignore the penalties imposed. The amendment excludes womens' health care services by excluding her right to purchase an option with her own money that covers abortion, requiring her to pay out of pocket for that specific service. How can that be legal with she is mandated to purchase an option and the only options available exclude a legal, medical procedure.
It may be elective but that is not the point. Hip replacements are elective and they are still covered. Cosmetic surgeries are excluded. Abortions are not like cosmetic surgery. The choice of having one or not should be the choice of the woman and any persuasion one way or another should be that churches and ministers and moralists should do a better job of counselling these women rather than domonizing them and that choice and condemning them as murderers.
I detest the fact that women were thrown under the bus in order to get this bill passed. As always, it's those in the most need - poor women faced with an unplanned pregnancy - who are becoming sacrificed due to partisan religious politics.
Here's a quote from US News and World Report that sums up the misery this amendment is likely to cause: "While the Stupak-Pitts amendment does allow women who want abortion coverage to purchase a separate rider along with their insurance policy, Richards says these riders are "discriminatory and illogical" since "women do not plan to have unintended pregnancies or medically complicated pregnancies that require ending the pregnancy." The National Women's Law Center has found that while five states already require separate riders for abortion coverage, the riders don't appear to exist in any insurance plans, public or private, that are offered in these states. Thus, none of the women in these states—North Dakota, Kentucky, Idaho, Oklahoma, and Missouri—appear to have plans that cover abortions."

That's like telling your child "Of course you can have a pet unicorn!"

Plus, even if these riders existed and women realized that hmm, one out of three women get an abortion at some point - it's likely that could happen to me, it's making women pay more for health care than men. Women make less money than men (71 cents to the dollar, I believe), and now more of that is going to have to go to health care.

This amendment is a hot mess, any way you look at it. I'm pissed.
Efforts like these are just a back door way of overturning Roe. Or making it irrelevant. It already seems pretty irrelevant. If you can't afford an abortion because there is no coverage and there are next to no providers because of violent intimidation tactics on the anti-abortion front, well then, what does it matter that the procedure is technically legal?
The reason the Republican Party has been taken over by religious extremists who want to impose their religious views on everyone else regarding abortion is because they know the importance of voting in primaries, which is when and how these people get elected.

A lot of people don't know the importance of their vote but the extremists do and they're motivated.

Money doesn't decide elections; voting does. Constituents need to make this clear to their elected leaders and let them know how they plan to vote.

Women are victims in so many ways and should learn the truth about their candidates before voting. It's a life or death matter.
If placating these fucking hypocrites and pretend Christians by doing this abortion exclusion is necessary to get this bill passed…go with it.

If Jesus actually is the Son of God…and if he has any pull with his Old Man at all…this hypocritical scum will have a special place in Hell reserved for them…just below the bottom level envisioned by Dante!
Say how you really feel, Frank. You're so shy!
I'm just as mad, but not nearly as shocked as most of you. Did you just arrive at the party? Cause women have been under the bus so long that the men just think they're speed bumps.
Let me get this right, the Republicans and conservative Democrats do not want government making medical decisions, but their anti-abortion amendment has the government deciding under what circumstances a woman can get an abortion. If they truly believe that abortion is the murder of an unborn child, they should have insisted that all abortions be prohibited under any government sponsored plan. Otherwise it is the government that is deciding who will live and who will die.
"Abortions can't be planned for - it is a medical procedure for unplanned circumstances." But this is like most medical problems. That aspect is just gravy for the Stupaks of the country.

"it is not necessarily a bad idea to keep that issue as separate as possible from then present issue about insurance reform. at least then these pro-life dems have a fig-leaf to cover their support."

It is a very bad idea. This bill should have been voted down, before the amendment. It does not get close to making health care affordable and is a bonanza for insurance companies, who are given 20 million or so new, forced customers. And the drug companies will not have to negotiate due to the deal worked out between them and Obama.

What is even more disgusting than the bill is that the amendment passed by a larger margin than the bill itself. The men took another opportunity to control the lives of women. Yes, the 17 R women voted for the bill, but they are auxiliary men. Two D women voted for it of the 59 D women in the House.
Digby: 97% of the Democrats who voted for the Stupak amendment were male. 90% of the Republicans were male.

"I don't want to pay for anyone's abortions, Viagra, cosmetic surgery, or for that matter mental health, which is an open-ended drain on resources."

As opposed to the "open-ended drain on resources" that are the wars this country endlessly fights? This whole "I don't want to pay for government spending I don't like" trope is nonsense. But, if we did that, we would have been out of the wars long ago. We would have single payer, universal health care long ago.

I don't want to pay the salaries of the health-industrial complex's CEOs. So what? We're all doing it and this bill will just expands their profits.

"If placating these fucking hypocrites and pretend Christians by doing this abortion exclusion is necessary to get this bill passed…go with it."

There is no reason to placate these assholes. They're going to get punished in the afterlife? Tell that to a woman who can't get an abortion, or anyone whose co-pay is unaffordable, as many of them will be for middle-class Americans.
thank you everyone for the comments...I am simply watching the conversation as you all discuss it
If this exclusion stands, and if ALL women of any socioeconomic status are prevented access to this legal procedure due to funding, I will simply detour all funds for political contributions to Planned Parenthood for the provision of the procedure to women who seek the service and cannot afford to pay out of pocket for it.
Agreed with Dave Edgar : you have thought this through quite well.
The problem : the amendment is the result of.. unthinking people, and has been proposed for unthinking people.
And... most of the comments here are from unthinking people too.
So... at some point in time what is REALLY essential is not the abortion issue itself, but the thinking problem.
When rational thought goes out the window, what are we left with ?
We're seeing it all over.