The power of the purse
How culture wars have morphed into an assault on women's health
After a slew of new Republicans toted their socially conservative agendas to Washington last November, the House has become the legislative outlet for right-wing opposition to women’s reproductive rights.
The pro-life movement’s assailments on abortion rights have often had far-reaching effects for basic reproductive health services. And in the current Congressional session, we’re witnessing this exact consequence. While these efforts demonstrate a patent disregard for the reproductive health and rights of all women, the provisions being pushed through the House are most detrimental to lower-income women and display a shocking lack of regard for their well-being.
The opposition to women’s reproductive rights specifically targets Planned Parenthood, a nonprofit organization that provides family planning services and education. Many of the measures also broadly attack women’s rights by imposing intolerable limits on the rights established by Roe v. Wade in 1973.
Before Roe, abortions were only legal in a handful of states. Elsewhere, the highly dangerous back-alley abortion was one of the few options for women who couldn’t afford to travel to another state or obtain a safer—but still illegal—underground abortion. By legalizing the practice, Roe moved the procedure from the dangerous realm of back-alley dealings to sterile operating rooms. Self-induced abortions—such as the infamous coat hanger procedure—were largely replaced by professional medical operations. Doctors could then provide regular post-op care.
Since 1973, however, social conservatives have attempted to stymie the right to choose that was granted by Roe, in many cases seeking to impose such stringent restrictions as to nearly eliminate it. Recent attempts to obstruct this right would disproportionately affect low-income women.
H.R. 3, the “No Taxpayer Funding for Abortion Act,” would make permanent the provisions of the Hyde Amendment, which has been routinely attached as a rider to the federal budget since 1976, and which bars federal funding of abortions except in cases of rape and incest.
The amendment is most inimical to lower-income women who rely on Medicaid, as well as Native Americans and military women who are covered by federal health care. The provision would also render abortion less accessible for privately insured women, as it would impose tax penalties on anyone under a private insurance plan that covers abortion services.
Without insurance, the cost of an abortion depends on factors like length of pregnancy, health of the mother, and any complications. These costs range from $350-$650 at an abortion clinic to $500-$700 at a physician’s office. Like most medical procedures, abortions are much more difficult to secure without insurance. For many Americans, these funding limitations would eliminate the pragmatic effects of the right to choose, rendering it a right in name only.
Beyond their disregard for women’s constitutionally-protected right to choose, current Congressional efforts also display an alarming lack of concern for women’s overall health.
H.R. 358, the “Protect Life Act,” features a conscience clause that would allow public hospitals to deny a woman the right to an abortion even in cases of abuse and in high-risk pregnancies when the woman’s life is at stake. This legislation reflects twisted priorities that value the right of the unborn over that of the already living. Under this bill, it would not be unfathomable for a pregnant woman to die due to a physician’s unwillingness to perform a life-saving procedure.
In another effort to eliminate reproductive health resources that overwhelmingly benefit low-income women, the House’s 2011 budget proposal would cut the $317 million allocation to Title X. This legislation is the only the only federal funding dedicated to family planning and was first signed into law by Richard Nixon as part of the Public Health Service Act of 1970.
Because of the Hyde Amendment, no Title X funding is used for abortion services. Rather, the program funds family planning services, including contraception and associated counseling. Any private organization that receives Title X funding must also offer a range of sexual and reproductive health services that include cancer, STI, and HIV/AIDS screenings; breast and pelvic exams; and testing for diabetes, high blood pressure, and anemia.
The beneficiaries of these services are generally low-income, young, or uninsured, and most have never had a child. Of the women served by Title X-supported clinics, 60 percent live below poverty level, while only 21 percent are covered by Medicaid. Title X helps fill the coverage gap created by Medicaid’s rigid requirements and provides an invaluable social safety net that allows millions of women to prevent unintended pregnancies.
While Title X’s history is littered with attempts to limit its scope, no previous Congress has dared to completely eliminate the program’s funding, which includes a $75 million allocation to Planned Parenthood.
Conservatives have also rallied behind the Pence Amendment, which would terminate an additional annual allocation of $330 million to Planned Parenthood and would bar the organization from receiving any federal funds in the future. By voting to erase Planned Parenthood’s federal funding, conservatives in Congress have demonstrated that their moral objections to abortion rights extend to the crippling of reproductive health services that overwhelmingly serve low-income women.
Planned Parenthood provides women access to education and affordable birth control in addition to abortion services. Although abortions account for only 3 percent of Planned Parenthood’s annual budget, the organization’s provision of the procedure puts the group at odds with pro-life politicians.
Meanwhile, Planned Parenthood estimates that 1 in 4 U.S. women receive health care from the organization at some point in their lives. Many of their patrons are young or uninsured, and Planned Parenthood provides a myriad of health services, including cancer screenings, HIV/AIDS and STI tests, and mammograms. In many cases, these clinics offer the only accessible resources for women who cannot afford more expensive alternatives at private hospitals.
Cecile Richards, president of the Planned Parenthood Federation of America, has decried the House’s budget proposal and the Pence Amendment as “the most dangerous legislative assault on women’s health in Planned Parenthood’s 95-year history.” The women who will feel the brunt of this assault are the low-income women who comprise the vast majority of Title X’s beneficiaries.
Those who oppose awarding federal funds to private organizations argue that these dollars free up private funds that will then be used for abortions. This convoluted relationship is tenuous at best and over-represents the amount of private funding that is actually used for abortion services.
Terminating Title X’s funding would do little to prevent abortions. Rather, it would encourage unintended pregnancies by limiting the availability of birth control and education. The Guttmacher Institute estimated that, in the absence of 2008 Title X funding, there would have been a third more unintended pregnancies and abortions. Preventing these unintended pregnancies saved taxpayers $3.4 billion in 2008—$3.74 for every dollar spend on contraceptive care. By defunding Title X, conservative Republicans will not accomplish their goal of limiting abortions. Instead, they are placing potentially lifesaving reproductive health services out of grasp for those who are not covered by private health insurance or Medicaid.
The right’s opposition to abortion rights extends from contentious funding cuts to perennial efforts to limit abortion access out of existence. While efforts to extend these limitations have been ongoing since 1973, the legislative proposals during the current Congressional session display an unprecedented lack of regard for the health of women and their Constitutionally-protected right to choose in favor of dangerous ideology.