A bill that would let women die

November 7, 2011

Rachel Cohen reports on the anti-abortion politics behind a proposed bill that would threaten women's lives by allowing hospitals to refuse them emergency care.

LET THEM die. That's what House Republicans and Democrats have to say to women who develop life-threatening complications to a pregnancy and seek emergency abortion services.

House Resolution 358, cleverly dubbed the "Protect Life Act" by its supporters, recently passed the House of Representatives. Only the latest in a record number of restrictions to women's reproductive health care considered in U.S. legislatures this year, the bill essentially doubles down on a few of the most dangerous and outrageous anti-abortion provisions currently in the law.

While the law is unlikely to pass in the Democrat-led Senate, House Republicans have Democrat Bart Stupak to credit for the framework of the bill. Stupak's effort to use the Congressional health care debate as an opportunity to attack abortion rights set the stage for an onslaught of legislative attacks that seems to grows more extreme by the month.

Much of Stupak's infamous amendment to the 2009 health care reform legislation was adopted as part of the Patient Protection and Affordable Care Act (PPACA). PPACA will already require individuals purchasing insurance through government insurance exchanges who choose a plan that covers abortion to write separate checks: one for their overall insurance and one for abortion coverage.

Representative Joe Pitts, sponsor of HR 358
Representative Joe Pitts, sponsor of HR 358

This "compromise" was as good as telling uninsured women the government won't stand in their way of riding unicorns into state insurance exchanges, since the effect of the amendment will strip abortion coverage from most insurance policies, not induce insurance companies to create special abortion coverage plans.

HR 358 would set this reality in stone by simply requiring insurers to exclude abortion coverage from plans sold in the state exchanges.

MORE ALARMINGLY, the "Let Women Die Act"--as pro-choice groups have more accurately termed the bill--significantly expands laws enabling health care providers to deny women a variety of reproductive health services.

As Planned Parenthood's website explains:

Under current law (through the 2004 Weldon amendment), hospitals, health care facilities and insurance plans can refuse to provide, pay for, provide coverage of, or refer for abortions. The Weldon amendment has no protections for patients to ensure they have access to care and information in a timely manner. HR 358 codifies this unfair and discriminatory provision.

Worse than even Weldon, HR 358 allows health care entities to refuse to "participate in" abortion care. This could mean that a hospital employee with no medical training or role in a patient's treatment decisions could refuse to process bills, handle medical records, or even set up an examination room.

HR 358 allows states to enact sweeping refusal laws that would allow health plans to refuse to cover women's preventive services, including birth control.

But the most staggering threat stems from the bill's attack on the 1986 Emergency Medical Treatment and Labor Act (EMTALA). EMTALA requires emergency health care providers to at least stabilize patients regardless of whether the patient can pay for their care.

HR 358 would allow staff in trauma centers and emergency rooms to deny treatment to women suffering from pregnancy complications, even if their life were endangered. Anti-abortion health care facilities wouldn't even be required to transfer patients hemorrhaging from a miscarriage or suffering sepsis from an intrauterine infection to another hospital.

In United States, over 80 percent of abortions are performed within the first 12 weeks of an unwanted pregnancy, the vast majority within the first 8 weeks. Later-term abortions are most often provided to very young women, very poor women, or to women who discover a threat to their health late in their pregnancy.

Women seeking emergency abortion services will most often be women who intended to carry their pregnancy to term. Denying care to a woman at risk of bleeding to death would have no affect on the number of women who seek non-emergency, first-term abortions. It would, however, threaten all women by eroding the principle that a woman's health is a real and justifiable consideration in reproductive health care legislation.

THE SOCIAL conservative right has often championed laws that let the beliefs of some trump others' civil rights, from the Weldon amendment to attacks on same-sex marriage. But offering so-called "pro-life" doctors the option to let women to die rather than end a pregnancy takes the logic to a low only surpassed by legislation weighed in some states earlier this year that sought to legalize the murder of abortion providers.

The claim that abortion is never justified is so extreme that even it's proponents can't avoid hypocrisy. Anti-choice former Senator Rick Santorum, for instance, has been a vocal opponent of abortion under any circumstance, except of course, when his own wife's pregnancy threatened her life.

Karen Santorum underwent a second-trimester, emergency abortion in 1996. The procedure involved inducing labor to expel the fetus--the very procedure the anti-choice right reviles as "partial-birth abortion." Yet Santorum has refused to change his position, insisting that anyone else's wife or loved one caught in the same circumstance should have been denied the care that saved his wife's life.

Unfortunately, threatening women's lives isn't the exclusive province of Tea Party Republicans. Already this year, state and federal governments have considered hundreds of laws restricting access to abortion and reproductive health care. The Guttmacher Institute reports that in the first six months of 2011, a record 162 bills were passed that restrict reproductive health care, more than have ever been passed in an entire year.

And while the "Let Women Die Bill" is unlikely to become law, it is designed to push the public policy debate farther to the right, testing whether women's health can be overthrown as the last, irrefutable defense for abortion.

In fact, all attacks on reproductive rights threaten women's lives and livelihoods. The more defensive a posture struck by mainstream pro-choice groups and the Democratic party, the further the anti-choice right will go. Unless the bipartisan assault on abortion is challenged by a defense of abortion rights for all women, in all circumstances, politicians of both parties will continue to compete to propose restrictions that roll back access to abortion to the vanishing point.

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