Should Abortions Be Insured, III

Listen, I try to have a civil tone here. I make an argument that there is a reasonable position to not use federal funds to pay for elective abortion. Those supporting that position, aren’t always so civil:

Writes Pilgrim Soul,

Charmingly I expect that in the next few days all your liberal dude friends will be trying to explain to you that this is really no big deal, look, they had to get the Republicans/”Democrats” onboard SOMEHOW, this is just a battle but we won the war, etc etc.

Actually, they’ll be explaining that it’s not a big deal because the Stupak amendment can be stripped out by the conference committee (which I very much hope it will, but am not holding my breath) and because there are potential loopholes (though I have yet to hear a convincing one).

This is not an argument, it is flatly dismissing men as being able to validly hold an opinion about abortion, at least if it one that a woman disagrees with. The post continues:

This has me so incredibly infuriated because it further segregates abortion as something different, off the menu of regular health care.

But you see, elective abortion is different. Forgive an analogy that will no doubt make some heads explode in rage, but the difference between non-elective and elective abortions is a bit like medically indicated breast augmentation and cosmetic versions. If someone gets a mastectomy as treatment for breast cancer or suffers from back pain due to excessive breast tissue, standard health insurance will typically cover this. Coverage of breast augmentation that is purely cosmetic is almost never covered. Such cosmetic surgery may (sadly) make a woman better off, and she should have a right to such surgery, but I don’t think anyone would support federal funding for the surgery.

Admittedly there are plenty of technically elective procedures that will be covered with federal funding. My knee isn’t going to kill me, it just might prevent me from being fully functional. All manner of wellness/public health measures could be counted as optional, though it would be bad for the country to fail to cover them. Abortion is arguably a wellness policy for the women involved (contraception certainly is). But that abortion is the subject of a moral debate is relevant. I don’t think anyone could plausibly claim that there is (or even should be) a constitutional right to a federally funded abortion, and absent that claim, it really is something best left up to the political process, a process that determined it is not ready to use funding for that purpose. Proponents have every right to make a political push to get the best treatment that is possible, whether it is federal funding or just a work-around to sort public from private funds.

As a pro-choice individual, I still think the matter of insurance coverage is a secondary concern (it being a polital one, not a civil rights one). Of great concern to me is the campaign of terrorism and general intimidation launched by anti-choice forces that have made lack of access (absent funding concerns) a real threat to the promise of choice, something that has been determined to be a right. I think that is where the focus of the movement’s energy ultimately should be.

Update: Kevin Drum offers a comment on the possible cost and insurance industry angle that I find interesting:

I wonder what the insurance industry thinks of this? I know that if I were an insurance company, I’d sure rather cover an abortion (cost = $500 or so) than a pregnancy carried to term (cost = $10,000 or so). But they’re probably too scared to speak up.

Would it be in the insurers interest to offer abortion coverage as a rider for free? I don’t know how many potential abortions under the plan would turn into pregnancies carried to term compared to abortions sought outside the plan. Either way, this incentive for the insurers to avoid paying for pregnancies would certainly seem to bring the cost of a rider to a pretty low level. With 1.2 million abortions performed in a year, I can’t imagine the odds of needing one for a specific woman in the public option or on subsidy (even though this population is very likely to be heavily skewed toward young adults) is very high. Perhaps a compromise for Congress is to have this rider established as opt-out for females and clearly distinguished from the standard funding pool.

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