When “Amanda” was 30, a condom failure led to an unplanned pregnancy. Living with her husband had taught her that he wasn’t likely to be a great provider—an alcoholic, he was bringing home less and less pay as he missed work more and more due to his heavy drinking. And his untreated severe depression led to other erratic behavior. The couple relied largely on Amanda’s low salary to get by in their expensive city. She chose to have an abortion, as it was covered through private insurance in her home state.
As of 2014, women in 21 states may not be permitted to make the same decision Amanda did.
The 2010 Patient Protection and Affordable Care Act was intended to expand access to healthcare beginning in 2014. But anti-abortion activists have found a way to use the ACA to further restrict abortion access in the United States.
In complying with the ACA, every state in the nation is required to put together a health marketplace, or “exchange,” by October of this year (unless they want the federal government to just do it for them, which most states do not). State residents who don’t have healthcare coverage through the government (for example, Medicaid) or through their employer will be required to purchase a health insurance plan through their state exchange.
That’s where anti-abortion activists saw an opportunity.
As clinic owner Diane Derzis told TakePart, “Wealthy women have always had access to a safe abortion.”
While no federal money may be used to pay for abortions, the procedure has long been covered under most private health insurance plans. However, states are now permitted to impose rules governing the private insurers who participate in state exchanges.
In Alabama, Arizona, Arkansas, Florida, Idaho, Indiana, Kansas, Louisiana, Mississippi, Nebraska, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Utah, Virginia and Wisconsin, those private insurers are expressly forbidden from covering abortions. Those are just the states that have passed such legislation since 2010; Kentucky, Missouri and North Dakota already had similar laws on the books.
Most of the states that ban “exchange” providers from paying for abortions do allow exceptions for when the mother’s life may be at risk, and some allow exceptions in the case of rape or incest. But that’s not true across the board—Missouri, for example, offers no exception if the pregnancy is due to sexual assault.
Mississippi is one of the states to enact a ban. Deirdra Harris Glover runs ProChoiceMississippi.org and is a volunteer member of Planned Parenthood of Mississippi’s Public Policy Board. She tells TakePart, “This ban leaves low-income women and families few options when faced with an unplanned pregnancy.”
Glover’s observation is particularly true in Mississippi, where the state is attempting to shut down its last remaining abortion clinic. As clinic owner Diane Derzis told TakePart, “Wealthy women have always had access to a safe abortion.”
Of course, as Glover observed, the same does not apply to poor women.
California has yet to enact a ban on abortion coverage in its future health insurance exchange, but pro-choice activists there are keeping careful watch on this national trend.
Serena Josel, public affairs director at Planned Parenthood of Los Angeles, tells TakePart, “The majority of private health insurance plans already cover abortion, and one of the key tenets of healthcare reform is that people would not lose the coverage they have today as a result of reform. These statewide abortion bans are unacceptable: They eliminate benefits and leave women worse off in terms of coverage.”
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Sara Benincasa is a blogger, comedian, and author of Agorafabulous!: Dispatches From My Bedroom. She has created online content for MTV News, Comedy Central, Vice, Wonkette, Jezebel, CNN and the Huffington Post. She holds a master's degree in education from Teachers College at Columbia University. She lives in Los Angeles, where she is at work on two novels for young adults.