Against medical advice, Corbett poised to sign another restrictive women’s healthcare bill
Update: The Inquirer is reporting that Governor Corbett signed this bill into law 6/17/13.
Rep. Donna Oberlander’s HB 818 would prohibit the coverage of abortion, even in cases of medical emergency, by private insurance companies selling healthcare plans through Pennsylvania’s soon-to-launch online state health-insurance exchange, established by the Affordable Care Act, a.k.a. Obamacare. (The new system should be in place by January 1, 2014.)
Despite criticism from the medical community (including an open protest letter signed by 63 Pennsylvania physicians), HB 818 passed both houses, and is expected to be signed into law by Governor Corbett this week. And once again, the bill’s advocates are misleading the public about what the bill does and doesn’t do.
Rep. Oberlander, hailing from Clarion County in western Pennsylvania, has said that this bill simply reinforces existing policies designed to prohibit tax dollars from paying for elective abortions. The part of that statement that’s true is this: Federal and state dollars are indeed prohibited from going toward abortion. The Hyde Amendment has prevented federal dollars from funding abortions except in very narrow circumstances since 1976; Pennsylvania also prohibits use of state funds.
Here’s the problem: HB 818 doesn’t just redundantly echo those long-standing policies. It doesn’t determine what medical procedures tax dollars will cover—it reaches into the coffers of private business to determine what procedures they will cover. It demands that private insurance companies that currently do cover abortion will have to alter their existing policy in order to participate in the exchange. (Note: The list of insurance companies participating in the Pennsylvania exchange will not be public until fall, per a spokesperson at the U.S. Department of Health & Human Services.)
“Let’s be clear: Under the Affordable Care Act, no taxpayer subsidy goes to fund abortion coverage,” Rep. Dan Frankel (D-Squirrel Hill) recently explained. The bill, he says, “goes much further and restricts women’s right to spend their own money. The real motive for this bill is to limit women’s choices.”
We’re not just talking “choice” as in American women’s constitutionally protected right to abort an unwanted pregnancy. No—HB 818 has been carefully designed to also limit the choices of pregnant women who suffer from medical conditions such as cancer or diabetes; who’ve been injured in a car accident; or whose doctors discover a severe fetal anomaly that would prevent the fetus from surviving birth or functioning.
Under HB 818, the only time an insurance company can cover an “elective abortion” (the phrase Oberlander likes to use) is in cases “where necessary to avert the death” of the woman, incest, and women impregnated by rape–providing they reported the rape to authorities. (The bill ignores the many reasons a rape victim may not report the attack. Also, PW has a request in with the PPD inquiring how communication between police, insurance reps, doctors and patients would work without hindering care.)
An amendment to expand exceptions to include the health of the mother was rejected by Pennsylvania lawmakers.
In this context, what’s the difference between averting immediate death and preserving health and life?
“It’s a very hard sometimes to distinguish,” explains Dr. Sherry Blumenthal, a physician at Abington Memorial Hospital and chairperson of the Pennsylvania chapter of the American College of Obstetricians and Gynecologists, an organization which is against HB 818. “We may perceive a serious life-threatening risk to the mother that doesn’t mean we are 100 percent sure the mother will die, but we feel that there is reasonable chance she could die if she maintains the pregnancy, or that there could be some significant impairment.”
Dr. Blumenthal says that she would be ethically obligated to explain to a pregnant patient in medical crisis that, for bureaucratic reasons, she has to distinguish between imminent threat to the patient’s life and “just” serious injury that could later lead to premature death—and the financial complications involved. “We have to tell a woman, ‘You could die if you do not terminate this pregnancy, but it will cost you, say, $30,000 to terminate this pregnancy.”
The health-exception amendment, offered by Sen. Judy Schwank (D-Berks), had been expected to pass; Schwank says she worked with Republican Senator Pat Vance to build a bipartisan alliance that would shepherd it through. The amendment failed by two votes. And not every vote cast against it came from a Republican: Sen. Tim Solobay (D-Canonsburg) and Sen. Richard Kasunic (D- Fayette/Somerset) crossed party lines specifically to disregard the health of pregnant women in Pennsylvania. Sen. Solobay did not return a call for comment.
“I certainly can’t understand why they voted for it,” said Schwank. “Let’s say a woman was pregnant, but her water broke prematurely and the baby would not survive. She would not be able to get an abortion. She would literally have to wait until birth was possible.”
In a recent interview, Rep. Oberlander’s explained her she did not allow for the health of the mother because it would create a “loophole wide enough you can ride a semi-truck through.”
“This isn’t, in my opinion, rocket science,” she added, about the bill.
HB 818 will make Pennsylvania the 22nd state to enact this kind of legislation, with varying degrees with exceptions.
Follow Tara Murtha on twitter at @taramurtha.