Richard Tallent’s occasional blog

The Michigan Abortion Law

My Facebook feed blew up today with articles about Michigan’s new law regarding abortions, which basically says that health insurance in Michigan can’t cover elective abortion by default, you have to pay for it ahead of time as a separate rider if you want it.

One thing that pisses me off about the press is that they rarely if ever actually link articles directly to the text of the bills and judicial decisions they cover, which allows them to just lazily report the outrageous statements on both sides of the issue. I finally found a copy of the bill on the site of the supporters, and I read it in its entirety (it’s short). A few Google searches later, I had a much better understanding of the law than the vast majority of the “journalists” reporting on the story.

Unfortunately, both sides are painting this specific bill as something far more important than it actually is.

The Republicans are acting like this is going to drastically impact the number of abortions performed in Michigan by making far more women pay out of pocket for abortion. It will do nothing of the sort.

The Democrats are acting like it is going to drastically reduce the availability of abortion to women who have miscarriages, or are raped, or are victims of incest. Again, this is hysterical nonsense.

Here’s the reality: this bill is a useless piece of Republican feel-good legislation that does next to nothing other than placating the pro-life wing, because, hey, if they can’t overturn Roe v. Wade, they can at least pretend they did something to save all the babies that they imagine will be killed once Obamacare kicks in and more people have insurance that might cover elective abortions.

So, here’s some context to keep in mind when discussing this bill:

  • The bill does not modify insurance coverage of D&C procedures after a miscarriage or ectopic pregnancy, or of abortions to save the life of the mother.
  • Medicare has not covered elective abortions in Michigan since 1987, so those patients were already paying out of pocket.
  • Nationally, only 12% of abortions are paid for using private health insurance in the first place (most paid out of pocket). Even 23 of women _who have insurance_ don’t claim it it on their insurance, either for privacy, or because it isn’t covered, or because the price for the procedure is close to or below their deductible. (Some additional people file claims for it later rather than having it direct-billed, but there are no good numbers on that.)
  • The average price for an elective surgical abortion is $480, less for a pill-induced abortion. While expensive, it’s a LOT less expensive than actually having a kid (medical, food, child care, lost wages, insurance premiums, etc.). Even the _deductible_ on a good insurance plan for a normal vaginal birth at a hospital is usually more than that. If people made the decision based on money, abortion would always be cheaper. Thus, not having it covered by default on insurance isn’t going to impact the number of abortions.
  • The ACA does not require all plans to cover abortion, nor does it allow taxes or tax credits to be spent on them.

This has been called the “Rape Insurance” bill, and that’s also nonsense. Michigan had 4,589 forcible rapes last year. Of those, research has shown that around 5% will result in pregnancy, and of those, half of the victims will choose to have an abortion. Add the 12% factor above, and this law will actually impact… drumroll please… 27 women per year who would have to have a rider on their insurance in place or else pay out of pocket.

Furthermore, most people (80% IIRC) get insurance from their place of work, and this law does allow employers to provide abortion coverage without the employee having to sign up for it. Many employer plans cover more than the bare minimum standards, so of those 27, a number of them will still have coverage already through their job without having to pay for a rider.

And even if all 27 don’t, how many of them will really choose to raise the child of their rapist rather than pay out of pocket?

So, this bill really has nothing to do with rape. Republicans are gaining nothing by not providing an exception for rape, it just makes them appear unsympathetic to rape victims while not actually reducing the number of rape-related abortions. And Democrats gain nothing but hyperbolic political points for calling this the “Rape Insurance” bill, because only a handful of abortions no longer covered will have been the result of a rape. 

I think the abortion debate in this country is just too high-strung to be of any positive policy benefit. I don’t think  anyone likes abortions, even the people who perform or have them, but rather than grandstanding with useless laws like this one, we should attack the primary sources of unwanted pregnancy, such as the lack of easily-available birth control. There is plenty of common ground to actually get laws passed to reduce the situations that lead to abortion. It doesn’t solve the rift between the parties on the core issue, but we may never resolve that argument as a society, and in the meantime we can do a lot together to make abortion a lot more rare.

Side thought: Obamacare’s mandates for health insurance, tax credits to afford it, expending of Medicare, and requirement that birth control be covered will do more to reduce the actual number of abortions in this country over the next 10 years than the last 30 years of “pro-life” supporters nipping around the edges of _Roe v. Wade_ and protesting outside of clinics.



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