By Jodi Magee
At Physicians for Reproductive Choice and Health, we know that abortion is an essential part of comprehensive health care for women, particularly for those with pre-existing conditions like heart disease or cancer. That’s why our doctors strongly object to the recent decision of the U.S. Department of Health and Human Services (HHS) regarding abortion.
The department has created an insurance program for the many Americans whose medical histories have made them uninsurable. The catch HHS won’t allow abortions to be covered by the new program. This policy makes no medical sense. It will not improve anyone’s health, but rather will hurt the patients the program is designed to protect.
Our physicians have witnessed and studied the harmful effects of withholding abortion care from women. For those whose health is compromised by a wide range of medical conditions, continuing a pregnancy may cause permanent physical damage or death.
Many of our doctors have treated women like Marie, a woman with lupus who needed an abortion when she developed dangerously high blood pressure and cardiac failure during her fourth month of pregnancy. Marie might have survived pregnancy and childbirth, only to be left with serious health problems, such as a stroke or kidney damage. These conditions would have made it difficult for Marie to care for herself and her children.
HHS rejects coverage of abortion for women in the new Pre-Existing Condition Insurance Plan (PCIP) except in a few very limited exceptions: cases of rape and incest and when the lives of the women are in danger. But the policy makes no exception for threats to a woman’s health, despite the extensive risks facing women in the Pre-Existing Condition Insurance Plan. Many of the women getting health care coverage from the Pre-Existing Condition Insurance Plan suffer from chronic medical problems, such as diabetes, hypertension, kidney disease, autoimmune conditions, clotting disorders, cancer and congenital heart disease. Pregnancy can seriously exacerbate each of these conditions, giving women an acute need for safe, affordable abortion.
Almost every obstetrician working in a major hospital has seen a woman die from complications of pregnancy. Many doctors have also saved women’s lives by ending pregnancies when the patients’ conditions worsened. Our physicians’ cumulative experience shows that women, particularly those with pre-existing health problems, must have abortion as an affordable, feasible option to protect their own health.
The abortion procedures for the women eligible for the Pre-Existing Condition Insurance Plan almost always require expensive hospital stays. The point of the Pre-Existing Condition Insurance Plan is to prevent economic catastrophe for high-risk patients. Pregnant women, like the rest of the patients eligible for the program, should not be forced to choose between their physical and financial health.
Take Alison, whose pre-existing conditions and medication regimen made it nearly impossible for her to find an effective method of birth control. She had a seizure disorder, a history of pulmonary embolism (blood clots), and kidney disease. Alison became pregnant by accident. Her physicians knew that her health would worsen with pregnancy; they just didn’t know if remaining pregnant would endanger her life. While deciding whether to continue her pregnancy, Alison had to factor in the cost of her abortion — a hospital bill in the thousands that could bankrupt her family.
Every woman, whether or not she is part of the Pre-Existing Condition Insurance Plan, has reproductive needs that vary enormously over the course of her lifetime. Many women need a range of medical care to stay healthy during their reproductive years, including birth control, vaccination, cancer screening, testing and treatment for sexually transmitted infections, prenatal care, pregnancy termination and menopause treatments. To deny women any one of these services is to ignore the reality of their health needs.
One in three American women will have an abortion by age 45, making it one of the most common medical procedures in the United States. Women seek abortions for a variety of reasons, including health conditions that worsen with pregnancy, developmental problems with the fetus and the inability to care for a child. Any insurance program that purports to cover women’s basic health needs must include abortion services as a covered benefit.
The board of directors of Physicians for Reproductive Choice and Health — which includes obstetrician/gynecologists, family physicians, internists and experts in family planning and maternal/fetal medicine — has unanimously urged the Department of Health and Human Services to remove abortion from the list of excluded services under the Pre-Existing Condition Insurance Plan.
Abortion is an integral aspect of reproductive health care and an essential service for women with underlying medical conditions. A government agency designed to serve the health needs of its citizens must not let the Pre-Existing Conditions Insurance Program hurt pregnant women and their families.
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September 27, 2010