Washington Post Column Profiles Federal Employee Forced To Pay For Medically Necessary Abortion Out Of Pocket

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Washington Post's "Federal Diary" columnist Joe Davidson on Tuesday profiled a federal employee who paid out of pocket for a medically necessary abortion because health plans participating in the Federal Employees Health Benefits Program are prohibited under federal law from covering the procedure. The law states that "no funds" under FEHBP "shall be available to pay for an abortion" except in cases of rape, incest or danger to the woman's life. Congress is considering adding similar restrictions to plans that receive federal subsidies under health reform legislation, Davidson writes, referring to an amendment sponsored by Rep. Bart Stupak (D-Mich.) that is included in the House version of the bill (HR 3962).

D.J. Feldman, 41, was 11 weeks pregnant when her doctor told her that the fetus had anencephaly -- a fatal defect resulting in the partial to complete absence of the brain and spinal cord. Feldman said that her doctor "made it very clear I wasn't to continue this pregnancy." According to Davidson, giving birth to an infant with the anencephaly can pose risks to the woman's health. Feldman's doctor wrote in a letter to her insurer that these risks include "dysfunctional labor and postpartum hemorrhage, which can increase the risk for the mother." The doctor added that the complications "are especially serious ... and could be life-threatening" for a woman Feldman's age. However, the Office of Personnel Management wrote to Feldman, "The fetal anomaly presented no medical danger to you, the mother." It continued, "Consequently, we cannot direct the (insurance) plan to provide benefits for the services in dispute." Feldman was able to negotiate the same $5,000 payment for the procedure that the insurer would have paid, compared with the nearly $9,000 she would have been charged as an individual, according to Davidson.

Stupak argues that women who want abortion coverage could buy supplemental insurance to cover the procedure under his amendment. However, those policies are often unavailable, Davidson writes. For example, the Government Employees Health Association does not offer supplemental abortion policies, according to Davidson.

Abortion-rights supporters are encouraged that a Senate appropriations bill would not renew the ban on abortion coverage for federal employees, though the House version includes the restrictions. Nancy Northup, president of the Center for Reproductive Rights, said, "This has been the first time in eight years to have the punishing restrictions removed from federal employees." Vicki Saporta, president of the National Abortion Federation, said, "Abortion is basic health care for women, and federal employees should have coverage" (Davidson, "Federal Diary," Washington Post, 12/1).

Guttmacher Clarifies Abortion Statistics

In a letter to the editor of the Wall Street Journal, Guttmacher Institute Executive Vice President Cory Richards clarifies statistics on insurance coverage of abortion that were cited in a recent article in the newspaper. He writes that it is correct that Guttmacher "estimates that some 160,000 women's abortions are currently direct-billed by the provider to private insurance plans annually, with an unknown, additional number of women seeking reimbursement after the fact" and that first-trimester abortions, which account for 90% of procedures, typically cost about $400.

"However, even putting aside the fact that later abortions, for instance in cases of fetal anomalies, can cost many thousands of dollars, neither of these figures is small, certainly not so small as to justify eliminating abortion coverage in private insurance plans," Richards says. He adds, "No one makes that case for other procedures that occur at similar rates or cost similar amounts, though for most people having to pay entirely out-of-pocket might not constitute an 'insurmountable burden.'" Richards continues that the "relevant" facts are that abortion is a legal procedure that is medically appropriate and in some cases medically necessary, and "its coverage by private insurance is currently the norm." Women "shouldn't be denied the ability to purchase insurance that covers abortion care regardless of how many women use this coverage today," he adds (Richards, Wall Street Journal, 12/1).

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.

© 2009 The Advisory Board Company. All rights reserved.

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