Economic policy

Banning Abortion Coverage Is Not Good Economic Policy, Not Good Health Policy, and Not Good for Rhode Island

When the representative Liane Cassar (Democrat, District 66, Barrington, East Providence) presented the Abortion Equality Coverage Act, her legislation to remove the abortion coverage bans that currently exist in Rhode Island’s Medicaid and state health insurance plans, she made a powerful and profound argument. Here are his lyrics, in full.

“I’m here to introduce you H7442, the Equality in Abortion Coverage Act, which would remove the abortion coverage bans that currently exist in Rhode Island’s Medicaid and state health insurance plans. It is an invasion of privacy and an invasion of personal freedom for the government to decide if and when a person is pregnant, giving birth and parents.

“Removing abortion bans in our state ensures that needed health care can be delivered when patients need it, regardless of how they pay for their care. Pregnancy is not a benign condition and it is not a neutral health event. Being pregnant can be and often is a physical and financial hardship. Giving birth can and often is a physical and financial challenge. It can be and often is a physical ordeal. It’s always a long-term financial commitment and for some, an ordeal for parents in Rhode Island.

We don’t have adequate support for parents, pregnant women and parents. We don’t have enough paid parental leave or adequate sick leave. We don’t have adequate mental health services for people with postpartum depression and we don’t have adequate early intervention services. We don’t have adequate support for parents with disabilities, or for parents raising children with disabilities. We don’t have adequate affordable child care and we don’t have adequate affordable housing. We lack the social service infrastructure to help families succeed, especially our lowest income families.

However, we have an increasing number of families suffering from hunger and homelessness. A lack of access to abortion is pushing people already marginalized by our struggling health and social service systems much closer to the edge. Pregnancy, labor, childbirth and parenthood are potential life sentences for people who are stuck in households where there is domestic violence. Even under the best health care circumstances, there are immediate physical impacts of pregnancy, labor, delivery, and the postpartum period. Birth and adoption are not reasonable alternatives to access to abortion.

Pregnancy has long-term adverse health effects and all too often there is a risk to the life and well-being of the pregnant person. The maternal mortality rate in the United States and Rhode Island has increased over the past 20 years with the highest rates among black, brown, and poor people. Data shows that black and Hispanic women are several times more likely to die in childbirth than their white counterparts in public health circles. Maternal mortality is an indicator of the overall health of the population. That this rate is increasing at a time in history, when we have access to high quality health care, should be alarming to all of us and a call to action across the country and here in Rhode Island.

In addition, there is a high rate of maternal morbidity, short and long term complications of childbirth. Black, brown, and poor people in Rhode Island have a higher level of maternal morbidity and are more likely to be readmitted to hospital for pregnancy-related complications in the postpartum period. Given that more than 60% of people who have abortions are parents, one can imagine the strain on a family, not to mention the cost of childcare, when someone has to be readmitted to hospital after giving birth. or if she experiences forced physical difficulties related to childbirth that prevent them from caring for their family or even returning to work.

“This is one of the many reasons why it should be up to the individual, not us legislators, whether or not to give birth. Receiving health insurance through Medicaid or health insurance plans from the state is not a choice, but a condition of an individual’s economic reality beyond its control – the inability to access abortion through Medicaid or health insurance plans the state.

Lack of access to abortion is not the result of market forces. It’s the result of a small number of lawmakers deciding that their beliefs should control the lifestyle and health care choices of people who receive Medicaid and state plans. In addition to removing an individual’s agency over their own body, limitations on access to abortion coverage impact our health care provider’s ability to provide quality care.

Our state’s obstetricians and gynecologists are some of the best healthcare providers in the country. They are highly trained and certified clinicians who work tirelessly to ensure the health and well-being of their patients. They are dedicated to advancing women’s health care through continuing medical education and through the practice, research and advocacy of their patients. They work to ensure the best health outcomes and they understand that there are cases, for personal economic and medical reasons, where a patient will not be able to continue her pregnancy.

Abortion bans, like the ones we have now, tie the hands of these medical professionals in the event of death or fetal loss or miscarriage, where an abortion would be medically indicated. If a patient is covered by Medicaid or a public health plan, that provider is limited in the services they can provide or access on behalf of their patient.

In these situations, the beliefs of complete strangers, in this case a small number of legislators in this building who oppose abortion without any knowledge or consideration of the medical reality facing a doctor and a patient, enter in the exam room and limit the options. When this is the case, care is often delayed to determine how to pay for services that insurance will not cover. And in the event of a pregnancy complication, any delay creates an increased health risk. This is the reality for Rhode Islanders who receive their health coverage through Medicaid. Those who are, by definition, poor – as well as for the 33,000 people, like us who work in this building and our family members, who are covered by state health insurance plans.

I urge my colleagues to resist the temptation to insert the beliefs of a small number of legislators into the examining rooms of a large number of health care providers and their patients. Pregnancy has significant and sometimes life-threatening implications, as well as significant financial implications for life.

“It should be up to the individual to determine if they are ready and able to go ahead with a pregnancy. As a state, we do not make parenting easy, and it is unacceptable for lawmakers to control the reproductive lives of people on Medicaid and state plans, just because we can, and because a small number of lawmakers think we should . I deeply and wholeheartedly trust women and others to make their own medical choices. They deserve the freedom that men and people on health insurance currently enjoy when it comes to making their own decisions. I deeply trust Rhode Island’s health care providers to care for their patients and provide the highest quality reproductive health services.

Maintaining a ban on abortion coverage is bad economic policy, bad health care policy, and bad for Rhode Island. Fortunately, the General Assembly has settled the question of whether or not abortion will remain available in Rhode Island in 2019. Now we just need to make sure that this right is real for all Rhode Islanders, regardless of or how they pay for their health care.

I urge this committee to defeat this bill and send it back to the assembly so that we can ensure that abortion is accessible to everyone.