On a recent Friday this month, women in an abortion clinic in Philly sit under the fluorescent lights of the waiting room. They’ve been there for hours. A patient is called in and one woman perks up, watching the other head through a door to the back. She deflates, saying, “Damn, I’ve been here since 9:30.”
Another woman asks, “What time is it?” She looks at her phone, sighing, cursing under her breath. “It’s 4:30.”
“Shit, it’ll be worth it, though,” another woman says, shaking her head.
One of them already has seven children. Like hens in a coop, the others cluck their disbelief. “Seven?!”
“Yeah, there is no way I can have another baby.”
The women talk openly about how they got there, and the mistakes they made. They talk about the birth control they will start using after all this is over and the herbs and “folk” remedies they tried in order to avoid being where they are now. And they speculate about how painful the procedure will be.
In the future, abortions might not be so accessible. If a few bills slowly making their way to Gov. Corbett’s desk are enacted, abortions could become more expensive and generally harder to obtain.
Two near-identical bills—Senate Bill 3 and House Bill 1977, which passed the House Monday night—seek to take away insurance coverage for abortions under Obamacare (aka the Patient Protection and Affordable Care Act). The president’s plan will require states to establish a health exchange for people to buy medical insurance.
“I think 70 to 80 percent of policies currently cover abortion,” says Maggie Groff, vice president of External Affairs at Planned Parenthood Southeast Pennsylvania. “Some women aren’t even aware that their health insurance covers abortion. You don’t know you have coverage until you need it. This would be a dramatic change.”
If Obamacare takes effect in 2014, abortion will not be covered under any of the policies on the state’s health exchange.
Women who can afford to, can buy separate coverage from a private insurer outside the exchange system. But low-income women whose health care is subsidized won’t get coverage if a pregnancy poses a serious health risk and abortion at a hospital is necessary.
“I’m just amazed at the people who are going to vote for this bill,” said Rep. Babette Josephs (D-Philadelphia) before the 146-45 vote. “They trust their constituents to vote for them, but not to make decisions for their own lives. That is unacceptable.”
Pennsylvania’s laws already prohibit using any public money for an abortion for a woman who qualifies for state medical health assistance, unless her life is danger or the pregnancy is the result of rape or incest. A “medical emergency” amendment that would provide an exception for pregnant women with conditions causing irrevocable physical harm such as severe illness or infertility without abortion of her pregnancy, was rejected.
“If a patient needs a higher level of care, she may need to be seen in a hospital where there are specialists,” Dr. Courtney Schreiber, assistant professor of Obstetrics and Gynecology at the University of Pennsylvania, writes in an email to PW . “(This legislation) makes no exception for catastrophic health situations such as … paralysis, organ failure and infertility. These bills are a true threat to women’s health.”
In a clinic, an abortion can cost from $350 to $425 and up in Philadelphia. About 80 percent of private insurance plans would cover this procedure in a clinic or a hospital, Schreiber writes. However, in a hospital, the price would be much higher.
“This is a very interesting dynamic here, by legislating what private insurance companies can or cannot cover in their services,” says Rebecca Foley, director of Public Policy at Women’s Way, a Philadelphia-based fundraising and advocacy group centered around women’s issues.
HB 1977 will now move to committee in the Senate, according to a staff member of the bill’s sponsor, Rep. Donna Oberlander (R-Clarion County) and SB 3 will move to the House for approval, according to Joe Pittman, the chief of staff of Sen. Don White (R-Indiana County), who authored the bill. Pittman says the state is exercising its right to decide what elective care will be covered on the health exchange.
Groff, of Planned Parenthood, smells politicking. “(In) the fact that it seems that they’re in a rush to deal with bills about abortion before these exchanges are even set up yet.” (With an election looming and the possibilities of a GOP ouster, it makes sense for a conservative legislature to get its laws on the books.) Another bill that passed the House on Monday night, HB 732, would require abortion clinics to renovate their facilities to comply with surgical standards—costly renovations that could potentially shut clinics down or raise the fees for services, Groff says.
“Between January and June of 2011, the Pennsylvania Legislature has spent over 30 percent of their time on the floor talking about abortion,” Groff says. “Really our lawmakers should be focusing on improving the health care system, instead of using bills as a political divisor.”