In the Wake of Health Reform, Abortion Under Attack

When health care reform finally limped past the finish line on
Capitol Hill, the compromises littering the final bill left many
activists disillusioned, but some hoped that action
on the state level
could keep the progressive
reform movement
moving forward. On reproductive rights, however, it
looks like the states are taking the lead in pushing back a woman's
right to choose.

This year, amid a resurgence of right-wing activism, hundreds of
bills targeting abortion have been introduced in state legislatures
around the country, many of which will deeply impact the rights of poor
women of color. Several conservative states have passed laws to block
coverage of abortion under the insurance exchanges established under
the overhaul-portending a tightening of abortion access even if it is
privately financed.

Oklahoma lawmakers have passed several controversial bills,
including constitutionally dubious measures that would
subject women to the psychological torment of having an ultrasound and
hearing a description of the fetus before undergoing an abortion.

The seeds of the current backlash, the New York Timesreports, were sown with a 2007 Supreme Court
decision on partial-birth abortions that chipped away at the legal
framework for legal abortion under Roe v. Wade. It's all adding up:

About 370 state bills regulating abortion were
introduced in 2010, compared with about 350 in each of the previous
five years, and 250 a year in the early 1990s, according to the
Guttmacher Institute, a research organization that supports abortion
rights. At least 24 of this year's bills have passed, and the final
total may reach the high of 2005, when states passed 34 laws, said
Elizabeth Nash, a public policy associate at the institute....

The assault on abortion rights will be felt most acutely among poor
women. On RH Reality Check, Pamela Merritt dissects the cruel psychological
manipulation underlying Missouri's Abortion Restriction Bill:

The Abortion Restriction bill requires abortion clinics to post
signs that promise state-backed assistance should a woman carry a child
to term and assistance in caring for that child once born. These
promised services include health care, housing, transportation, food,
clothing, education, and job training. Given the fact that the Missouri legislature slashed funding
to most of the
programs that would have provided those services, those claims and
promises aren't worth the poster-board they will be printed on.

By tying the refusal of an abortion to social services, Missouri
masks its punishment of poor women as a "reward" for keeping an
unwanted pregnancy. Adding insult to injury, they've also betrayed the
same promise by tearing apart the safety net that should be available
to all women, regardless of how they choose to exercise their
reproductive rights.

Missouri is a microcosm for a slow-burning crisis in reproductive
health that targets poor communities and communities of color, in which
abortion has become more prevalent in recent years.

According to Raising Women's Voices, while the federal
subsidies and Medicaid expansions will broaden women's access to the
mainstream health care system, the new benefits come at the expense of
reproductive health for the most vulnerable:

  • Women on Medicaid and those who will become eligible for
    Medicaid in 2014 will not be able to use their coverage for abortion
    services in most cases, except in the circumstances stated above, or if
    they live in one of the 17 states that use state-only dollars to
    provide abortion coverage under Medicaid.
  • Low-income women receiving care at Community Health Centers
    still will not be able to receive federally-subsidized abortion
    services, making it more difficult for CHCs to provide this care.
  • New funding for ineffective abstinence-only sex education.
    Title V, the federal abstinence-only-until-marriage program is
    resuscitated and given $50 million a year for five years.

Additionally, immigrants, regardless of legal status, will continue
to face discriminatory restrictions under the pending health reforms.
This includes a five-year mandatory wait to qualify for federal
Medicaid services for green card holders, along with a total ban for
undocumented women.

The health care system is at the cusp of major changes in the coming
years, delivering a mix of help and hurt. But for the women whose
reproductive health needs have always been ignored in Washington, the
biggest change they'll see could be from bad to worse.

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