New York Times Opinion Piece Argues That Benefits Of Health Reform Would Outweigh Negative Impact Of Stupak Amendment

Main Category: Abortion
Also Included In: Health Insurance / Medical Insurance
Article Date: 26 Nov 2009 - 3:00 PDT

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The debate over abortion coverage in the House health care reform bill (HR 3962) "exaggerates the extent to which the Stupak amendment would really change things for women seeking abortions," Phillip Levine, a professor of economics at Wellesley College, writes in a New York Times opinion piece. The amendment, named for sponsor Rep. Bart Stupak (D-Mich.), would prohibit public and private insurance plans receiving federal subsidies from covering abortion services. According to Levine, the debate also "obscures the other benefits that expanded health insurance coverage could bring to women's reproductive health," such as increased access to family planning, he writes.

Levine writes that the Stupak amendment's "effect on any individual woman's insurance coverage for abortion depends on what kind of insurance she has now." He says that of the 62 million U.S. women of childbearing age -- ages 15 through 44 -- about 12% are currently covered by public insurance programs, such as Medicaid. These women would not experience any change in abortion coverage because current law already prohibits the use of federal funds to cover abortion services in those programs, he writes. People with private insurance, including about 42 million women ages 15 through 44, "would be at risk" for coverage changes because insurers "could decide to drop all abortion coverage in order to ensure their eligibility to participate in public insurance exchanges," Levine continues.

However, Levine argues that women covered under private insurance policies "are not as likely as women with no insurance or public insurance to have abortions." In addition, they "tend to be older, with higher family income, and women in these groups are much less prone to seek abortions," he says. He adds that the abortion rate among women with incomes below the federal poverty level is four times as high as for women with incomes above 300% of the poverty level. "Only 6% of women of childbearing age with private health insurance live in poverty; 62% have incomes above 300% of the poverty line," according to Levine. He also contends that "[e]ven if women with private health insurance find themselves seeking an abortion, the out-of-pocket cost for the vast majority of them is not that high relative to their income." Women in need of abortions after the first trimester "could potentially be affected more seriously, as these abortions are considerably more expensive," Levine writes.

"What is being overlooked in this debate is the benefit to women's reproductive health that would most likely occur if insurance access were expanded," Levine continues. About 89% of private insurance plans currently cover contraceptive services, according to Levine. "Presumably, if health care reform provided insurance to more women, those who gained coverage would receive family planning services as well," he says. According to Levine, about 7% of the 12.4 million uninsured women of childbearing age give birth each year. He also cites his own research finding that expanded Medicaid coverage from 1990 to 2003 decreased unintended childbearing by 9% as a result of increased use of contraception. Levine argues that if reform provided health insurance to 10 million women of childbearing age, a 9% reduction in their fertility rate would prevent 63,000 unintended births. "I do not mean to understate the importance of the abortion debate taking place," Levine writes, concluding, "Yet this debate should not overshadow the tangible benefits to women's reproductive health that could be brought about by expanded insurance coverage" (Levine, New York Times, 11/25).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

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