It’s 2013 and the Pennsylvania General Assembly continues to attack women’s access to reproductive health. According to WeveHadEnoughPA.org, the Pennsylvania legislature has launched and maintained a 2+ year attack on women’s health. There have been numerous bills introduced and in some cases passed that restrict women’s vital access to reproductive health.  Since January 2011, there have been at least 55 votes in the Pennsylvania General Assembly to restrict access from birth control to safe, legal abortions.

The most recent attack is happening this month.  On April 10, the Pennsylvania Senate Insurance and Banking Committee heard and passed out SB 3 by an 8-5 vote; a floor vote could occur any time this month.  This coming Monday, April 15^th, the Pennsylvania House Health Committee will be hearing and voting on HB 818, the companion bill to SB 3.

The Additional Burdens on Women Seeking Abortion Care in These Bills

Both of these bills would prohibit insurance companies who provide health care coverage from including abortion coverage within the new healthcare Exchange crafted by the Affordable Care Act (aka Obamacare). The only exceptions to this proposed ban are for women who become pregnant because of rape or incest if they personally report the sexual assault to law enforcement officials and for women who will die without immediate access to abortion services. If a woman doesn’t meet one of these two exceptions, she must completely pay for the abortion totally out of her own pocket, unlike any other medical care she would receive under her health insurance plan.

Currently, about 80% of private insurance companies provide coverage for abortion services. This is important because these very same plans will be offered to people purchasing insurance through the Exchange. As part of the federal law, however, all plans that offer abortion coverage in the Exchange must have a separate payment for that portion of the coverage. This bill would deny women the right to make this separate payment and deny them what is currently available to most people covered by the current private health insurance system. While women would still be able to have abortions in this circumstance, they would be forced to fully pay out-of-pocket all cost for these procedures; their insurance company would be prohibited from paying any portion of this treatment.

This proposed ban places an undue burden on victims of rape and incest and on those women whose lives are in danger health-wise by adding unnecessary barriers to receiving the critical medical attention they need. The two exceptions allowed are extremely limited. These bills require woman who are victims of rape or incest to notify the police and identify the perpetrator prior to seeking abortion treatment.  It also limits women with health issues that complicate their medical treatment to those that are in immediate danger of dying and requires additional medical certification by second, non-attending physician.

This bill places these restrictions on access to health insurance not by mentioning rape or incest or the death aversion clause, but by referring to and expanding Pennsylvania’s version of the Hyde Amendment.  This language is embedded in 18 Pa.C.S. § 3215(c) and would expand restrictions on public funds to all privately paid insurance plans purchased within the Exchange. The law (18 Pa.C.S. § 3215(c))as currently written is a prohibition of the state spending of public funds but not personal funds provided by the person herself for her own health insurance coverage.

The Rape and Incest Exception

Women and minors who are raped would be denied access to abortion services unless they formally report and identify their rapist to the police or child protective services.  Most sexual assaults are not reported to the police. This is even truer when the perpetrator is a family member or acquaintance. According to the Pennsylvania Coalition Against Rape, sexual assault occurs at a much higher rate than is actually reported.

Reasons for not reporting include an initial denial that they have been raped; fear that you won’t be believed or are ashamed for having been raped; or having an ongoing relationship (such as a spouse or parent) with the perpetrator. In order to be safe from further violence by the perpetrator, women and girls may decide not to report the attack to the authorities.  And if you are in denial you are also unlikely to report your rape or the incest of your child to authorities as required in this proposed legislation.

So that means if this bill becomes law and you become pregnant from rape or incest, you are further burdened with the additional costs of fully paying for the abortion. If this bill were not to go into effect, then following the restrictions placed on abortion care under federal law, you would have the abortion services covered based on the insurance rider you purchased in the exchange and you wouldn’t be forced to file a complaint with the police.  This is just one reason why this bill should be voted down.

The “Avert” Death Exception and Need for Expanded Health Exception

In addition, under this proposed law, women who are near death could receive an abortion.  However, say a woman develops cancer or an infection during her pregnancy that will not immediately kill her but would complicate her medical treatment should she continue with the pregnancy.

This health threat/complication is not included in the current bill’s health exception as that exception allows abortions only to “avert” the woman’s death. Any woman with a medical condition that is complicated by the pregnancy but doesn’t immediately place her in danger of death would be forced to bear the additional burden of the full cost of an abortion in addition to the increased threats to her health as well as the additional medical bills for the remaining part of her care.  The medical community, advocates and some legislators are very concerned about this limited exception and have proposed an amendment to both the House and Senate bill to expand this exception from “averting” her death to coverage of the abortion for any pregnancy that poses a substantial risk to the woman’s physical health.

But even if the health exception is expanded to include threats to women’s physical health and care, this bill continues to attack women’s health and lives and should be voted down.

Why this Bill Should be Voted Down

The question of whether abortion will be covered in federally subsidized insurance exchanges has already been settled.  In response to concerns raised by US Senator Ben Nelson, a staunch opponent of abortion, women who want to use their own money to purchase a health insurance plan that covers abortion services must send a separate payment so the funding for abortion coverage is completely separate and paid entirely by the individual. This bill denies women their right to make this separate payment.  And with an estimated 80% of private insurance plans currently covering abortion care, banning abortion coverage in the state exchange would leave women worse off than they were before health care reform began.

Abortion care is a legally authorized and fundamental component of women’s basic health care.  Women should not be denied access to safe, legal, and critical care as part of health care reform implementation.

If abortion coverage is available to some, it should be available to all.  Politicians should not discriminate against women participating in the health insurance exchange.  All women deserve the same peace of mind that they can obtain the health care they need, regardless of where their insurance comes from.

The decision to have an abortion is a private decision between a patient and her physician. It should not be denied by politicians interfering with an insurance company and the policies they offer to the consumer for this procedure.

Banning abortion coverage in transactions between a private company and an individual is governmental activism of the worst kind.  With all of the heated rhetoric over healthcare reform, one would assume that lawmakers would be sensitive about taking any action that suggests government intervention in private healthcare decisions.

Finally, instead of denying Pennsylvania women access to fundamental reproductive health care services, politicians should be working to protect and advance women’s health.

Action Needed

Contact your Pennsylvania Senator and Representative today (find their contact information here).  Tell her/him to support the expanded health exception amendment to both SB 3 and HB 818 and to oppose the entire bill regardless of the inclusion of the amendment.