PRCH Board Chair on Smith Abortion Bill (H.R. 3)

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Testimony of Douglas Laube, MD, MEd Board Chair, Physicians for Reproductive Choice and Health Submitted to the House Judiciary Committee Subcommittee on the Constitution February 8, 2010
Physicians for Reproductive Choice and Health (PRCH) is a doctorled national advocacy organization. Since 1992, PRCH has used evidencebased medicine to promote sound reproductive health policies. PRCH’s network of physicians includes practitioners in obstetrics and gynecology, pediatricians, fertility doctors, family physicians, cardiologists, neurologists, radiologists, and others. We believe in reproductive choice for everyone. PRCH welcomes the opportunity to submit testimony on H.R. 3, misleadingly named the “No Taxpayer Funding for Abortion Act.” Other organizations will certainly discuss in detail the possible impact of this bill on the private insurance market for abortion and consequences for the tax code. As an obstetrician/gynecologist who represents a large network of physicians, I will discuss the women and families whose lives will be affected by this dangerous legislation. Every day my colleagues and I treat women who are able to use their insurance to obtain needed medical care. Sadly, we also see women struggling to make the best decision for themselves and their families without the financial resources to pay for an abortion. H.R. 3 would not only decimate private insurance coverage for abortion, but also contains very limited exceptions that make no provision for a woman’s health. This bill ignores the
very real situations women face and, if enacted, would have a devastating impact on their ability to access safe and legal abortion care. In my practice in Wisconsin, I had a patient, Beth.* Beth was pregnant with her first child and looking forward to becoming a mother. Three months into her pregnancy, she developed dangerously high blood pressure. Without an abortion, she could have had a stroke or kidney damage. She made the very hard decision to end her pregnancy. Beth’s medical condition is just one of many that can complicate pregnancy. But H.R. 3 would leave women like Beth without insurance coverage for abortions necessary to protect their health. My colleague and fellow PRCH board member Dr. Nancy Stanwood from Rochester, New York, has seen the impact of policies such as this. She had a patient, Carol, who was excited to give birth to her first child. Her husband was a Marine, serving in Afghanistan. Their health insurance was provided through the military. Sadly, in Carol’s second trimester, she learned that her baby had anencephaly; it would be born without a brain. After much painful deliberation, she and her husband chose abortion. They were shocked to learn that their health insurance would not cover the abortion and would only cover situations where Carol’s life was in danger. Her husband was outraged, telling Dr. Stanwood, “I’m over there defending my country, and they won’t even take care of my family?” Under this bill, insurance coverage could be barred for heartbreaking situations like Carol’s. Dr. Kristina Tocce in Denver treated a patient with a complicated pregnancy. An ultrasound showed that her patient Consuela’s fetus was not developing kidneys. Most infants with this problem do not live more than a few hours. Also, Consuela’s placenta was covering the opening to her cervix; this condition, if left untreated, can result in life-threatening bleeding during delivery and requires a cesarean section. Conseula and her husband decided to terminate
*
All patient names have been changed to protect confidentiality.
the pregnancy, but her insurance was through Medicaid. Because Consuela’s medical condition did not yet endanger her life, she did not qualify for abortion coverage under Medicaid’s life exception. Out of pocket, her abortion would have cost more than $4,000, an impossible sum. Consuela continued to carry the pregnancy and suffered tremendous emotional turmoil. Six weeks later, her fetus died in utero. The legislation under consideration would put women all over the country into situations like Consuela’s. In Seattle, Dr. Deborah Oyer had a patient, Allison, a 34-year old mother of three with an unintended pregnancy. She was still deciding whether to continue her pregnancy when she discovered her youngest child had leukemia. She and her husband quickly realized that they could not have another child at that time. Allison needed to take leave from work and stay at the hospital with their daughter for the many treatments to come. Her husband needed to stay at home, two hours away from the hospital, to work and care for their two other children. Fortunately, Washington Medicaid covered her abortion. But Allison and her family would have faced great hardship if they had had to pay out of pocket. Access to affordable insurance that covers abortion is essential for women and their families. H.R. 3 also has an expansive refusal clause that allows individuals and entities to refuse to provide abortion care, potentially even in emergency situations. Dr. Sara Imershein in Washington, DC, cared for a pregnant mother of two, Brenda, who had vaginal bleeding and bulging membranes—a sign in this case of an inevitable miscarriage. Brenda needed an abortion to stop the bleeding and avoid having a blood transfusion. The religious hospital where she was being treated opted to transfer Brenda across state lines to another facility, where she did need to have a blood transfusion. Treatment at the original facility would have been safer and less expensive. Such refusal to provide immediate medical care harms women.
For these real women and their families, abortion was a difficult decision made after consultation with their physicians and consideration of the medical issues involved. Abortion was a critical medical procedure that protected their physical health as well as the health and well-being of their families. While the egregious trivialization of rape has reportedly been removed from the bill, H.R. 3 still threatens millions of American women by making insurance coverage for abortion impossible to obtain. No consideration is afforded to protect women’s health. Real women like Beth, Consuela, Allison, and Brenda will suffer as a result. It is critical to the lives and health of American women that this bill be defeated. On behalf of PRCH, I thank you for the opportunity to submit this testimony.