Reporting
After Stupak, Abortion Advocates Consider Reframing the Issue
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The day after Rep. Bart Stupak (D-Mich.) introduced his eleventh-hour amendment, feminist writers and activists were livid. Ann Friedman at Feminsting wrote, "So what the FUCK is this Stupak amendment doing attached to the health-reform bill? You know, that amendment that takes away women's access to health care?" On Meet the Press after the amendment passed, Rachel Maddow called it "the biggest restriction on abortions since the Hyde amendment."
Ultimately the Affordable Care Act passed with a somewhat lesser restriction on abortion, an amendment put forth by Sen. Ben Nelson (D-Neb.) that will require women to pay for their abortion insurance separately. Stupak and Nelson justified their positions with an amendment put forth by Sen. Henry Hyde (R-Ill.) in 1976—just three years after Roe v. Wade legalized abortion in America—that says no federal funding can be used to pay for abortion care. Since then, the amendment has ridden on the backs of several other "must pass" bills, discontinuing abortion care under Medicare and other federally-run health care programs.
Now, abortion rights activists are beginning to re-think their strategy, in part because the Stupak amendment re-ignited a new generation of young activists on the issue of abortion. Catholics for Choice weighed this question at a recent panel discussion at the National Women's Democratic Club in Washington, D.C. Many pro-choice activists and public health analysts went over reasons abortion still isn't included in coverage under Medicaid, Medicare, or the new health care reform bill.
“It’s ridiculous to say we have the right to an abortion, but you couldn’t get the funding through Medicaid," says Stephanie Poggi, executive director of the National Network of Abortion Funds (NNAF), a nonprofit that raises money for low-income women to pay for abortions. “It was part of the attack on legal abortion and prevents hundreds of thousands of women from making that decision because they cannot afford it.”
The NNAF makes an effort to help these women who would not otherwise be able obtain abortions without assistance in obtaining funding. Each year NNAF receives about 90,000 calls from women but have only been able to give funding to about 21,000.
“Some of these women had already gone the distance to put together the money; they use the money they would normally use for necessities—food, rent, [and] health care—for their abortion, and still do not have enough,” Poggi says. “These are the working poor we’re talking about here.”
Despite the fact that the Stupak amendment was ultimately defeated, President Barack Obama agreed to a compromise of signing an executive order along with the bill to ensure "that existing limits on the federal funding of abortion remain in place under the new health care reform law."
“Abortion rights have been offered up as a bargaining chip, even though, right now, if you have health insurance, abortion is usually covered in the package,” says Dr. Suzanne Poppema, a retired abortion provider from Washington State and long-time advocate for providers who speaks on behalf of Physicians for Reproductive Choice and Health. “As individual practitioners, we are powerful in what we can do for our patients, but powerless policy-wise.”
But although the Hyde amendment restricts abortion funding on the federal level, states have a right to use their own funds for abortion if they want to. Currently 17 states provide funding for women on public assistance programs to cover abortion care. Only four of those states provide funding voluntarily through passing legislation; the remaining passing provisions mandate state funding for abortion under court orders.
“The abortion issue has been so well isolated and shamed that it appears evil to provide abortion care,” Poppema says. “It’s not about the babies, it’s about controlling women. Until we can say this care is part of women’s overall care and stop isolating ourselves, it will still be a problem.”
Over 40 percent of women who have abortions live below the federal poverty line, or $10,830 per year for a single woman with no children. But it's women who are nearly as poor who make up the second-largest group of those seeking abortion; 27 percent of women obtaining abortions have incomes between 100-199 percent of the federal poverty line, or women making between $10,830 and $21,660 a year, according to the Guttmacher Institute.
Poggi acknowledges that anti-choice advocates will say that the woman should not have had sex if she doesn't want to risk pregnancy. But Poggi says that the ability for a woman to control her reproduction isn't always her choice; choosing to reproduce means being able to control her life. Since 1994, unplanned pregnancy rates among low-income women have increased by 29 percent, while rates among higher-income women have decreased by 20 percent.
Contraception also plays a large role in abortion rates, with over 17 million women each year getting publicly supported contraceptive care—a number which grew by roughly 400,000 between 2000 and 2002 due to a rising uninsured population. Researchers estimate that one in five women aged 15-44 were uninsured in 2005—a 10 percent increase since 2001, according to the National Family Planning and Reproductive Health Association.
Sometimes the actual providers of care sometimes add an additional block to federal funding. In 2005 the United States Conference of Catholic Bishops noted that 573 Catholic hospitals treated 84.7 million patients, which often do not include abortion care in their health care.
“Forty-seven percent of hospital beds today are … Catholic Church [affiliated]. And these hospitals do not provide reproductive services,” Poppema says. “As public hospitals get stretched for money, the Church comes in and buys them. It puts abortion providers in a tough place because we cannot provide the care even if we want to.”
While there are many political and religious reasons women have difficulty accessing abortion care, women on the panel earlier this month debated whether the pro-choice community needed a new rhetorical framework to discuss the issue.
“We need new language and new frames to view the two sides,” says Lourdes Rivera, program officer for sexuality and reproductive health and rights at the Ford Foundation. “We cannot win against ‘life.’ How can you argue that? What we need to do is reframe it; we are for the lives of women. Pregnant women are people too, and they deserve the medical care to decide to give birth or not.”
Nancy Belden, a strategic research and communications firm at Belden Russonello & Stewart, breaks down the way people look at abortion and how it affects policy.
“Most people do not want to restrict abortion, but they also don’t want to give an open-door option, where it’s like birth control,” Belden says. “It does not matter whether or not they know anything or not about abortion and the realities. It’s what people think is happening or what they imagine. They think it’s easy to get an abortion.”
Belden suggests reframing the fight for funded abortion not through the ideas of “choice,” but through “medical privacy,” an idea she says most Americans can get on board with. In 2009, Belden's firm interviewed 923 catholic voters and found that when it came to the issue of health care reforms that may include coverage for abortions, voters largely reject the argument that Bishops should be publicly oppose heath care reforms if included abortion. Two-thirds of Catholic voters disapproved of Bishops saying that all Catholics should entirely oppose health care reform if the plan includes coverage for abortions, and four in ten strongly disapprove (39 percent). Three in ten approve, but only 16 percent strongly approve of bishops taking this position.
“We should be asking people, ‘should we be letting the government or clergy make these decisions for us?’ That’s an idea people can get behind,” Belden says. “They will want abortion to be reduced, but they also don’t want to take the choice out of people’s hands.”
Lisa Gillespie is a former staff writer for Campus Progress as well as the Managing Editor & New Media Director at Street Sense. She graduated from the University of North Carolina–Asheville.
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