McDonnell Abortion Policy Ignores Medical Reality

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    The General Assembly rejected Gov. Bob McDonnell’s attempts to kill Big Bird and the rest of the gang on Sesame Street – by eventual elimination of funding for public broadcasting – and his proposal to switch Medicaid mental health services to a managed-care plan. However, the legislature did go along with his restriction of state funding for abortions to cases of rape or incest or when the life of the mother is at risk. Previously, the law also allowed Medicaid to pay for abortions if the health of the mother was at risk.

    Perhaps the predominately male legislature doesn’t know exactly what sorts of health problems the former policy addressed. We aren’t talking here about women who believe that their pregnancy will make them “feel bad.” There are actual, serious medical problems that no longer will be covered.

    Del. Jennifer McClellan, (D-Richmond) who happens to be pregnant herself, explained how the new limits on abortion will have unintended consequences for the health of women in Virginia. “I’ve had time to talk through this with my own OB (obstetrician) and get real-life examples,” she said.

    The procedure to treat hemorrhaging because of an incomplete miscarriage is the same as an abortion under this new law. Virginia law will not distinguish between that situation – which can cause severe bleeding, indeed the remote possibility of death – and a regular abortion. Now, I can’t conceive of any doctor not treating a woman on Medicaid for that condition, but now someone will have to pay the cost, either the  medical facility or ultimately insurance rates for all of us.

    Sen. Ralph Northam (D-Norfolk), a doctor, also explained that the governor’s amendment would leave some women, such as those with diabetes, facing possibly dire health consequences from pregnancy. A severely diabetic woman carrying a pregnancy to term could suffer serious damage to her eyesight and possibly lose kidney functions. Northam pointed out that the woman’s health would be seriously impaired, but since her life would not be in immediate danger, an abortion would not be available.

    I can attest to the truth of that in my own family. My nephew’s wife has serious type 1 diabetes. She has been told that pregnancy for her would probably result in loss of kidney function and possibly early death.

    Other people have questioned whether the new state policy will also restrict the choice of state workers also since state funds are used to pay most of their insurance costs.

    All of those people who have been running around screaming that the recently passed federal health reform bill constitutes the government trying to practice medicine are dead wrong. That law simply extends health insurance coverage to 35 million Americans not presently covered by insurance. This change in Virginia law, however, IS the state government practicing medicine. Why? Because it is telling doctors what they will get reimbursed for and what they won’t. That affects the patients many doctors will be willing to see.

    Medicaid reimbursement to doctors is already so much lower than for other patients that many health care providers have stopped participating in the program. I can’t think of any way that this new Medicaid policy won’t further limit the number of providers for women on Medicaid. In rural areas of the state that could be devastating for maternal health.

    I respect those who for religious or personal conviction are adamantly opposed to abortion. I wish they respected my views, in return.

    I personally agree with the basic outlines of Roe v Wade. The first trimester of a pregnancy should be off limits for governmental intrusion. The state has a right to regulate the second trimester and to severely limit abortion in the third trimester. I also agree with those who insist that parents should be notified before a minor child can have an abortion, with protection of the child from parental anger. I absolutely believe that abortion without a medical reason after the fetus has become viable should be outlawed; however, I also respect women and doctors more than politicians to make the right health care decisions.

    Unfortunately, Bob McDonnell doesn’t have that respect. He simply has – once again – satisfied his base at the expense of other Virginians. First, it was black Virginians ignored in his Confederate proclamation. Now, it’s women.  

    • WestEndVoter

      McDonnell’s language leaves a lot to be desired.  That being said, it is difficult to draft text which allows abortion payment for the diabetic situation, but denies abortion payment

      for women who believe that their pregnancy will make them “feel bad.”

      and similar situations.

      I’m guessing that pro-choice politicians (particularly in the Senate) were not armed with enough “tough case” examples to justify an expansion over Medicare coverage.

      The best I could suggest is that “tough cases” be specifically enumerated next term, and then proposed as individual bills.  That way, you would force a politician to affirmatively indicate that, e.g., a diabetic mother could not have a state-funded abortion.  While unlikely to pass until McDonnell is out, it could be a good political move, depending on your viewpoint on the issue.

      Another alternative is to provide for a panel review of “tough cases”, but this would likely result in a lot of administrative expense, and could probably be killed on that basis alone.

      From personal experience, I am very concerned about an interpretation that would exclude a D&C after partial miscarriage, do you have a reference or citation?

           

    • jack

      The article you cited had a more detailed explanation:

      McDonnell’s amendment limiting funding for abortion services only to those allowed under Medicaid was approved on a 64-30 vote after impassioned debate.

      If the “completion of an incomplete miscarriage” is not covered, it is because it is not covered by Medicaid.

    • jack

      I also respect women and doctors more than politicians to make the right health care decisions.

      Unfortunately, Bob McDonnell doesn’t have that respect. He simply has – once again – satisfied his base at the expense of other Virginians.

      He’s not saying that women and doctors cannot make those decisions, only that other Virginians are not going to pay for it.  What’s wrong with that?