The Return Of Back-Alley Abortions
Underground abortions have returned to the United States, just as pro-choice activists have warned for years. And women have started going to jail for the crime of ending their own pregnancies, or trying to.
This week Jennie L. McCormack, a 32-year-old mother of three from eastern Idaho, was arrested for self-inducing an abortion. According to the Associated Press, McCormack couldn’t afford a legal procedure, and so took pills that her sister had ordered online. For some reason, she kept the fetus, which police found after they were called by a disapproving acquaintance. She now faces up to five years in prison, as well as a $5,000 fine.
Idaho recently banned abortions after 20 weeks, and McCormack’s fetus was reportedly between five and six months old. But according to Alexa Kolbi-Molinas, a staff attorney for the ACLU’s Reproductive Freedom Project, under Idaho law, McCormack could have been arrested even if she’d been in her first trimester because self-induced abortion is illegal in all circumstances. “It doesn’t matter if it’s an 8- or 10- or 12-week abortion,” says Kolbi-Molinas. “If you do what you could get lawfully in a doctor’s office—what you have a constitutional right to access in a doctor’s office—they can throw you in jail and make you a convicted felon.”
While horrific, McCormack’s case is not unique. In recent years, several women have been arrested on suspicion of causing their own abortions, or attempting to. Most have come from conservative rural states with few clinics and numerous restrictions on abortion. In America’s urban centers and liberal enclaves, the idea of women being prosecuted for taking desperate measures to end their pregnancies might seem inconceivable, a never-again remnant of the era before Roe v. Wade. In fact, it’s a slowly encroaching reality.
Even more, these cases demonstrate that criminalizing abortion means turning women who have abortions into criminals.
In 2005, Gabriela Flores, a 22-year-old Mexican migrant worker, was arrested in South Carolina. Like McCormack, she had three children and said she couldn’t afford a fourth, and so she turned to clandestinely acquired pills. (The drug she took, Misoprostol, is an ulcer medicine that also works as an abortifacient and is widely used in Latin American countries where abortion is illegal.) Initially facing two years in prison, she ended up being sentenced to 90 days.
In 2009, a 17-year-old Utah girl known in court filings as J.M.S. found herself pregnant by an older man who is now facing charges of using her in child pornography. J.M.S. lived in house without electricity or running water in a remote part of the state, several hours’ drive from the nearest clinic, which was in Salt Lake City. Getting there would have required not just a car—her area had no public transportation—but money for a hotel in order to comply with Utah’s 24-hour-waiting period, as well as for the cost of the abortion itself.
According to prosecutors, when J.M.S. was in her third trimester, she paid a man $150 to beat her in the hopes of inducing a miscarriage. The fetus survived, but she was charged with criminal solicitation to commit murder. When her case was thrown out on the grounds that her actions weren’t illegal under the state’s definition of abortion, legislators changed the law so they would be able to punish women like her in the future.
Meanwhile, prosecutors have appealed J.M.S.’ case to the Supreme Court, and observers expect it to rule against her. She could still face a trial and prison time.
A woman doesn’t even have to be trying to abort to find herself under arrest. Last year, a pregnant 22-year-old in Iowa named Christine Taylor ended up in the hospital after falling down a flight of stairs. A mother of two, she told a nurse she’d tripped after an upsetting phone conversation with her estranged husband. Though she’d gone to the hospital to make sure her fetus was OK, she confessed that she’d been ambivalent about the pregnancy and unsure whether she was ready to become a single mother of three.
Suspecting Taylor had hurled herself down the stairs on purpose, the nurse called a doctor, and at some point the police were brought in. Taylor was arrested on charges of attempted feticide. She spent two days in jail before the charges were dropped because she was in her second trimester, and Iowa’s feticide laws don’t kick in until the third.
These cases are a harbinger of what’s to come as abortion laws become increasingly strict and abortion clinics harder to access in the more conservative parts of the country. They demonstrate the lengths to which women will go to end unwanted pregnancies. But even more, they demonstrate that criminalizing abortion means turning women who have abortions into criminals.
The antiabortion movement likes to see itself as pro-woman. Most of its spokespeople talk about protecting women from abortion, insisting they’re not interested in seeing them punished. “It’s tragic that this young woman felt that this was her only way out,” National Right to Life President Carol Tobias said in a statement in response to questions about the McCormack case. “The pro-life movement has never supported jail sentences for women who are victims of the abortion culture and abortion industry.”
Tobias said her group calls on Idaho officials “to engage in more publicity about the network of pregnancy resource centers and about the existence of Idaho’s safe haven law—either of which would have helped this young mother and saved her child.” But she didn’t call on them to release McCormack or to change the laws under which she’s being charged. If these sorts of prosecutions aren’t what the antiabortion movement had in mind when it pushed wave after wave of state-level legislation, now might be a good time to speak up.
By: Michelle Goldberg, Contributing Writer, The Daily Beast, June 3, 2011
Ryan Plan “V” Word: A Voucher By Any Other Name…
When President Obama met with congressional Republicans this week, GOP leaders were particularly incensed about Democrats using the word “voucher” when describing the Republican plan to end Medicare. Paul Ryan and others prefer “premium support,” and consider the Dems’ rhetoric to be “demagoguery.”
There are two main problems with this rhetorical disagreement. The first is that the GOP plan really does rely on vouchers, whether the party cares for the word or not. The second is that plenty of far-right Republicans are inclined to ignore their party’s talking-point instructions.
Here, for example, was Sen. Ron Johnson (R) of Wisconsin, a Tea Party favorite, explaining one of the things he likes most about his party’s Medicare plan.
“What I like about the Paul Ryan plan is it’s trying to bring a little bit of free-market principles back into Medicare.
“If you need subsidized care, we’ll give you vouchers. You figure out how you want to spend. You select what insurance carrier you want to use. It’s a start.”
It’s not just Johnson. Last week, GOP presidential hopeful Herman Cain argued, “Nobody’s talking about the fact that the centerpiece of Ryan’s plan is a voucher. Now, a lot of people don’t like to use that term because it has a negative connotation. That is what we need.” Even Fox News has referred to the Republican plan as being built around “vouchers.
If conservative Republicans are using the word, why is it outrageous when Democrats do the same thing? Are Johnson, Cain, and the Republican cable news network all secretly siding with the left?
As for the substance behind the claim, it’s worth noting that this isn’t just about semantics — the GOP claim that their scheme doesn’t include vouchers is just wrong. Paul Krugman explained yesterday:
[T]he ACA is specifically designed to ensure that insurance is affordable, whereas Ryancare just hands out vouchers and washes its hands. Specifically, the ACA subsidy system (pdf) sets a maximum percentage of income that families are expected to pay for insurance, on a sliding scale that rises with income. To the extent that the actual cost of a minimum acceptable policy exceeds that percentage of income, subsidies make up the difference.
Ryancare, by contrast, provides a fixed sum — end of story. And because this fixed sum would not grow with rising health care costs, it’s almost guaranteed to fall far short of the actual cost of insurance.
This is also why Ryancare is NOT premium support; it’s a voucher system. No matter how much they say it isn’t, that’s exactly what it is.
Given this reality, why do Republicans throw such a fit about the use of the “v” word? Because vouchers don’t poll well. For the right, the key is to come up with phrasing, no matter how deceptive, that persuades the public. If GOP leaders throw a big enough tantrum, they’re hoping everyone — Dems, pundits, reporters, even other Republicans — will use the words they like, rather than more accurate words that make the party look bad.
No one should be fooled.
By: Steve Benen, Contributing Writer, Washington Monthly Political Animal, June 4, 2011
Health Reform in Massachusetts: Self-Serving For Mitt But Also True
Mitt Romney’s defense of the Massachusetts health care reforms was politically self-serving. It was also true.
Despite all of the bashing by conservative commentators and politicians — and the predictions of doom for national health care reform — the program he signed into law as governor has been a success. The real lesson from Massachusetts is that health care reform can work, and the national law should work as well or even better.
Like the federal reform law, Massachusetts’s plan required people to buy insurance and employers to offer it or pay a fee. It expanded Medicaid for the poor and set up insurance exchanges where people could buy individual policies, with subsidies for those with modest incomes.
Since reform was enacted, the state has achieved its goal of providing near-universal coverage: 98 percent of all residents were insured last year. That has come with minimal fiscal strain. The Massachusetts Taxpayers Foundation, a nonpartisan fiscal monitoring group, estimated that the reforms cost the state $350 million in fiscal year 2010, a little more than 1 percent of the state budget.
Other significant accomplishments:
The percentage of employers offering insurance has increased, probably because more workers are demanding coverage and businesses are required to offer it.
The state has used managed-care plans to hold down the costs of subsidies: per capita payments for low-income enrollees rose an average of 5 percent a year over the first four years, well below recent 7 percent annual increases in per capita health care spending in Massachusetts. The payments are unlikely to rise at all in the current year, in large part because of a competitive bidding process and pressure from the officials supervising it.
The average premiums paid by individuals who purchase unsubsidized insurance have dropped substantially, 20 percent to 40 percent by some estimates, mostly because reform has brought in younger and healthier people to offset the cost of covering the older and sicker.
Residents of Massachusetts have clearly chosen to tune out the national chatter and look at their own experience. Most polls show that the state reforms are strongly supported by the public, business leaders and doctors, often by 60 percent or more.
There are still real problems that need to be solved. Small businesses are complaining that their premiums are rising faster than before, although how much of that is because of the reform law is not clear.
Insuring more people was expected to reduce the use of emergency rooms for routine care but has not done so to any significant degree. There is no evidence to support critics’ claims that the addition of 400,000 people to the insurance rolls is the cause of long waits to see a doctor.
What reform has not done is slow the rise in health care costs. Massachusetts put off addressing that until it had achieved universal coverage. No one should minimize the challenge, but serious efforts are now being weighed.
Gov. Deval Patrick has submitted a bill to the Legislature that would enhance the state’s powers to reject premium increases, allow the state to limit what hospitals and other providers can be paid by insurers, and promote alternatives to costly fee-for-service medicine. The governor’s goal is to make efficient integrated care organizations the predominant health care provider by 2015.
The national reform law has provisions designed to reduce spending in Medicare and Medicaid and, through force of example, the rest of the health care system. Those efforts will barely get started by the time Massachusetts hopes to have transformed its entire system. Washington and other states will need to keep a close watch.
By: Editorial, The New York Times, May 20, 2011
The Truth About Waivers: Protecting Coverage For Millions Of Americans
Today, you might have seen news stories about waivers from certain provisions of the Affordable Care Act. There has been no shortage of confusion and deliberate obfuscation on this issue and we want to ensure you have the facts.
Under the Affordable Care Act, we have implemented new rules that phase out, by 2014, health insurance companies’ ability to slap restrictive annual dollar limits on the amount they will pay for your care. But between now and 2014, we also want to make sure workers are able to maintain their existing insurance, because on their own they would likely be shut out of the individual market or face unaffordable options. To do that, the Affordable Care Act allows the Department of Health and Human Services to issue temporary waivers from the annual limit provision of the law if it would disrupt access to existing insurance arrangements or adversely affect premiums, causing people to lose coverage. So far, we have granted 1,372 of these waivers to employers, health plans, and others in all 50 states, covering less than 2 percent of the insurance market and protecting coverage for more than 3.1 million Americans. We have been completely transparent about this process, announcing the waiver process in a regulation last summer, publishing clear guidance on the application process on our website, and posting a list of waivers we have granted on our website.
These temporary waivers will not be available beginning in 2014 when annual limits are banned and all Americans will have affordable coverage options. And millions of Americans – including many small business owners – will be able to shop for affordable coverage in new competitive marketplaces.
Some have raised questions about waivers that were recently granted to companies in California. So there’s no confusion, here are the facts:
- A company called Flex Plan Services is a third-party administrator that provides benefit administration services for employers in a number of states, including: California, Washington, Alaska, and Georgia. One type of plan they administer is known as a health reimbursement arrangements (HRA or employer contributions to a tax free account). Many of the company’s clients are hotels, restaurants and home health agencies, all of whom employ low-wage workers.
- On March 23, Flex Plan Services submitted 92 waiver requests on behalf of 45 employer clients. On April 4, 2011, HHS approved the request.
- HHS applied the same standard to the application from Flex Plan Services that it uses when reviewing any application for a temporary waiver. Waivers are only available if the plan certifies that a waiver is necessary to prevent either a large increase in premiums or a significant decrease in access to coverage.
- In addition, enrollees must be informed that their plan offers coverage with a restricted annual limit.
- No other provision of the Affordable Care Act is affected by these waivers: they only apply to the annual limit policy.
The Affordable Care Act puts an end to many of the worst insurance company practices including refusing to sell a policy to a family because someone had cancer or a child has asthma; cancelling coverage when a patient files claims because of an unintentional mistake in their paperwork; and slapping annual or lifetime limits on how much care you can receive. When these rules are fully in place in 2014, our country will be much better off and the cost of coverage will be within reach for the millions of Americans who now live day to day without coverage, worrying about an injury or an illness that could plunge them into bankruptcy. To get from today’s broken system to tomorrow’s patient-centered system takes time and patience through a reasonable transition period. But, together, we will get there.
By: Richard Sorian, Asst. Sec for Public Affairs, HHS, The White House Blog, May 17, 2011
Insurance Companies: Guarding Health Is Not Their Business, But It Is Ours
If for one moment anyone has the notion that for-profit health insurance companies are in the business of guarding the health (or wealth) of policyholders, that notion ought to be quickly dismissed in favor of the truth. For-profit health insurance giants guard profits.
I arrived outside the WellPoint annual shareholders meeting in a hotel in Indianapolis yesterday to be greeted by more guards (and some armed) than I have seen surrounding President Obama at times. Apparently just the prospect of having some of the legal shareholders question the business practices and ethics of the WellPoint board and CEO Angela Braly was very scary for the company and its elite leaders.
Some of the shareholders have in recent years put forward a resolution supporting WellPoint’s return to its non-profit roots. After last year’s meeting, the resolution earned 9.6 percent or 30,000,000 shareholder votes. The current leadership doesn’t like that nor do they like the efforts of the shareholders who keep challenging them.
One shareholder asked Ms. Braly at yesterday’s tightly controlled and guarded meeting, as a sort of speakers’ “shot clock” counted down her speaking time, “Tell me, Ms. Braly, could you please explain what you do that warrants a salary ($13.5 million annually) that is more than 375 public school teachers in Indiana earn?” Braly’s answer was a classic. No shot-clock running for the CEO as she explained that the board sets her compensation and it has to be competitive with the other comparable giants in the insurance industry. It is a breathtaking demonstration of greed and hubris.
I wondered how we have allowed this country to amble onward to the point where 1,275 Americans who carry health insurance go bankrupt every single day (if the courts stayed open seven days a week) while an insurance company CEO like Angela Braly pockets $140,000 for her day’s salary. Every day.
That’s quite a lot of money that doesn’t go to healthcare. That’s quite a lot of money for one person to earn in one day. That may be why such scary guards are needed outside WellPoint shareholder meetings – they wouldn’t want CEO Braly to have to mix it up with any of the policyholders or others who might question too directly what value the for-profit health insurance industry adds to the U.S. healthcare system. I also wondered how much money those guards cost. And the shot clocks to keep pesky questions to a minimum? And how about the pro-Angela and pro-profit softball questions planted in the room?
WellPoint, like the other major insurance giants, can claim the best profits ever this year. Times are good at the top. Things are not so good for millions of Americans who want for decent healthcare within a system that provides a progressively financed, single standard of high quality care. Medicare for all would be nice. The American Health Security Act of 2011, S915/HR1200 as offered by Sen. Bernie Sanders, I-VT, and Rep. Jim McDermott, D-WA, provides a model for moving forward. Public financing (yes, a single payer system) coupled with public and private delivery (not a single provider). No insurance giants paying huge board compensations and CEO salaries. No armed guards protecting the profit.
Outside the City Market in Indianapolis, in the rain and with no need for guards, the advocates of healthcare sanity gathered – and I was thrilled to be among the Hoosiers for a Commonsense Health Plan. We affirmed our commitment to the work ahead and to one another. We sang. We are shareholders in a society that values more than profit – we value behaving justly and humanely, and we’d like a healthcare system that reflects that.
Forgive my repetition of the theme, but health insurance is not healthcare. Health insurance is a financial product. Health insurance is a financial product sold to protect health and wealth which may well do neither. Health insurance is a defective financial product for millions of people who made what we felt were responsible decisions about protecting ourselves and our families from financial or health disaster with health insurance products that have loopholes and flaws big enough to leave thousands dead every year and hundreds of thousands bankrupt.
I will never have the salary or earnings of insurance CEOs like WellPoint’s Angela Braly. That’s OK by me because I’ll also, I hope, never need guards to keep those I have harmed and those I would harm from questioning me about why. But, my life and the lives of my loved ones, my neighbors and my friends are surely as valuable in terms of access to healthcare in America in 2011. The day will come.
By: Donna Smith, CommonDreams.org, May 18, 2011