Health Insurance, Abortion and Symbolism

An article in today’s WSJ goes through the numbers explaining why restricting insurance coverage for abortions as now being debated on Capitol Hill would do little in practical terms to change the affordability of abortion for the vast majority of women.

Yet the financial impact of the restrictions — the House’s overhaul bill, H.R.3962, would prohibit insurance bought with government subsidies from covering abortions –- isn’t the whole story. People on both sides of the debate say another issue is that when insurance covers abortion, it reduces the stigma associated with the procedure.

Amy Hagstrom Miller, who owns abortion clinics in Texas and Maryland, instructs her staff to ask patients if they want to pay with insurance. One reason is because the very question conveys the message that abortion is a mainstream procedure, to be treated like any other aspect of medical care.

Critics of the House bill say the coverage restrictions would send the opposite message. “It makes it even less likely that abortion will ever be normalized in this country,” Carole Joffe, a sociologist who supports abortion rights and studies the issue at the University of California at Davis.

Exactly the point, say abortion opponents.

They hope that pushing abortion out of the mainstream will discourage more women from making an appointment. There is some evidence that state laws requiring women get counseling at a clinic, then wait 24 hours before terminating a pregnancy cuts abortion rates. The House bill could have the same effect, activists say.

“You want to communicate that abortion is in a different moral category than a tonsillectomy” and eliminating insurance coverage is one way to do that, said Charmaine Yoest, president of Americans United for Life, an advocacy group opposed to abortion.

The debate on Capitol Hill about abortion coverage is mostly symbolic, said David DeWolf, a law professor at Gonzaga University who opposes legal abortion. “But it’s symbolic,” he said, “in a way that deeply matters to a lot of people.”