The Children’s Health Insurance Program (CHIP) is on shaky ground.
Part of my daytime job is to monitor and report out all the latest news on CHIP, and let me tell you, it’s not always a pretty picture. Since running out of funding earlier this fall, the health coverage of 9 million kids and teens under 19 years old is now up in the air.* Despite promises to extend CHIP, Jimmy Kimmel’s heartfelt pleas, and tons and tons of research showing the impact of inaction, several states are now warning families that, hey, they might need to look elsewhere for their children’s routine check-ups, immunizations, and prescriptions.
It’s not a good look to begin with: throwing vulnerable communities into a lurch and deepening their hole into poverty as things like rent and utility bills and groceries are traded in just to get the essential health care services they absolutely deserve.
Is that a bleak picture for you? Well, it gets a little worse. Did you know CHIP also plays an extremely important role in reproductive health care for these low-income kids and teens?
In the United States, nearly all of teen pregnancies are unplanned. One report from the Guttmacher Institute has the number as high as 75 percent! (And even more harrowing, teens in the low-income brackets are more likely to become pregnant, which is the exact demographic CHIP covers.) But through initiatives like CHIP, all teens—regardless of income—can have access to the reproductive health services they need. Which, in my view, is really awesome.
It’s a well known fact that women who decide to become pregnant and have access to quality family planning information are better prepared for the demands of a pregnancy. But let’s face it: not all things can be carefully planned. That’s where prevention comes in. Sadly, low-income kids, teens, and their families are more often than not the ones who cannot afford access to reproductive health care and the resources to prevent unintended pregnancies. But CHIP helps to bridge that gap!
From routine gynecologic exams to sexuality education and pregnancy testing to pregnancy care, CHIP helps prevent pregnancies in the first place, and, if they happen, helps these teens have better delivery, healthier babies, and healthier lives. Ultimately, it’s a win-win: reducing the rates of unintended pregnancies for teens in low-income communities leads to huge net public savings. For example, in 2010, publicly funded family planning services saved over $15 billion bucks.
With all these amazing things that CHIP does, it’s mind-boggling that funding hasn’t been extended. If our elected officials can’t reach agreement on extending funding for CHIP, they are taking away low-income adolescents’ access to basic reproductive health services. Again, not a good look.
*CHIP covers 9 million uninsured, low-income children whose parents earn too much for Medicaid, but not enough to afford other types of private coverage. Learn more about CHIP.
By volunteer Kaitlyn B.
Kaitlyn is the Communications Specialist at Georgetown University’s Center for Children and Families.
This week, the House of Representatives passed H.R. 36, which would criminalize abortion after 20 weeks of pregnancy, with exceptions for situations in which the life of the pregnant person is at risk or the pregnancy is the result of rape or incest and the survivor meets the criteria for reporting or receiving treatment for the assault. Doctors can be punished by up to five years in prison and/or fines if caught performing or attempting an abortion after the cut off.
Sen. Lindsey Graham introduced this heartless measure in the Senate with the support of 45 other senators. The bill is based on ideology rather than science, and DC Abortion Fund opposes the measure.
Abortions after 20 weeks are rare, but increasing barriers to access, including mandatory waiting periods, forced ultrasounds, limited clinic options, and high out-of-pocket costs, put patients at risk of having an abortion closer to the 20-week mark. In addition, each week that a patient has to wait to have their abortion procedure performed can add hundreds to thousands of dollars to the price tag and make the procedure more complicated (while still safer than childbirth).
At DCAF, we support patients who need later abortions the same way we support patients who need earlier abortions. We are appalled at this legislation, and promise to serve our patients as we always have: with dignity and respect.
Now more than ever, patients are relying on abortion funds to help cover some of their costs. Please consider donating to DCAF. Your gift helps us remove some of the financial barriers that patients face when trying to access an abortion, and sends a message to Congress that we will not stop fighting for and with our patients.
If you have senators, please contact them at (202) 224-3121 and ask them to oppose this cruel abortion ban.
Kentucky could be the first state in the nation without a single abortion clinic, depending on the outcome of a recent federal court case. The Louisville abortion clinic EMW Women’s Surgical Clinic is the only open clinic in the state and closure would severely limit safe, legal and high-quality reproductive healthcare for women.
EMW, joined by Planned Parenthood of Indiana and Kentucky, filed suit in 2016 after receiving notice that the clinic’s abortion license was to be revoked. The state cited deficiencies in transfer agreements from the clinic to local hospitals even though it was originally approved. A federal judge issued a temporary restraining order so that the case would remain open until a judge ruled on it. The groups are asking U.S. District Judge Greg Stivers to overturn regulations that they argue are medically unnecessary and create an unconstitutional barrier to abortion. The three-day trial concluded on September 8, but a ruling could take months.
Back in January this year, the Kentucky state legislature passed two new laws limiting abortion access: one making it illegal for women to get abortions at or after 20 weeks of pregnancy and the other requiring women to obtain and view an ultrasound before having an abortion.
Lawyers from the American Civil Liberties Union and Planned Parenthood, who are representing the clinic, argued that the state’s regulations “impose an undue burden” on a woman’s constitutional right to an abortion. These regulations are cited by the Kentucky government as the reason for revoking the clinic’s abortion license.
According to the Courier-Journal, during the trial a state health regulator blamed hospitals, saying they failed to provide sufficient agreements with EMW. EMW and Planned Parenthood alleged that the state pressured or intimidated hospital officials into declining to enter into these agreements.
What reproductive rights stories are you reading? Share with us on Twitter at @DCAbortionFund.
by volunteer Amy M.
“The Trump administration’s decision to end Deferred Action for Childhood Arrivals (DACA) leaves 800,000 DREAMers and immigrant youth who call the US home at risk of deportation. For many of them, the US is the only home they’ve ever known. Without DACA, they don’t know what their futures hold or if they will be able to stay in this country. The DACA program provided peace of mind and a voice, including things that many of us take for granted, such as the ability to pursue higher education and hold a driver’s license.
“Rescinding DACA is yet another act of white supremacy. It is rooted in racism. The same systems that pardon people like Joe Arpaio and orchestrate mass deportations are the ones that are putting our ability to access health care at risk. We all deserve protection, health, and freedom no matter our immigration status.
“We at DCAF believe that borders shouldn’t get in the way of people’s health, education, livelihood, or family. We condemn the administration’s actions and are holding our community close during this time.
“Our community is stronger when we stand together. We will continue to serve our patients, regardless of immigration status. To our patients, volunteers, and community members who are impacted by this uncertainty: You are not alone. We support you.
“We encourage everyone to visit weareheretostay.org for resources and opportunities to take action now.”
by DC Abortion Fund Board of Directors
Many of us are concerned about how the Trump administration’s efforts to repeal and replace the Affordable Care Act (ACA) will impact access to sexual and reproductive health care, especially for marginalized folks. With Republican leadership drafting their bills in secret, plus attempting to rush votes on them without hearings or much floor debate, it can be difficult to understand what is going on. The numerous moving parts only add to the confusion.
I’m here to break down four ways that any effort to repeal and replace the ACA would spell disaster for full spectrum sexual and reproductive health care access:
It would gut coverage of essential health benefits, many of which include aspects of sexual and reproductive health care
The ACA includes a list of essential health benefits that all insurance plans must cover—in many cases at no cost to the insured individual. This includes FDA-approved forms of birth control and a yearly gynecological visit plus screenings for breast cancer, cervical cancer, mental health, intimate partner violence, and STIs, as well as the Hepatitis B and HPV vaccines. The list also includes pregnancy care, childbirth, and breastfeeding support. Under the new legislation, insurance plans would no longer be required to cover some or all of these services. That means we could be forced to go back to the pre-ACA era where only 12% of individual market plans covered pregnancy care and the cost of needed services such as long-acting reversible contraceptives or early cancer detection were out of reach for many. People would instead be at the mercy of state laws regarding whether or not these services must be covered. For instance, only twenty-eight of the U.S. states have laws which mandate contraception coverage and not all of these laws provide the comprehensive protections under the ACA. Thus, a GOP health care bill threatens contraception coverage under public and private insurance plans alike.
It would defund Planned Parenthood, putting its clinics’ ability to stay open in jeopardy.
When our foes talk about “defunding Planned Parenthood,” they are referring to revoking its clinics’ ability to receive Medicaid reimbursements for the services they provide. Never mind that federal funding for abortion care is already prohibited under the Hyde Amendment (states in which Medicaid does cover the procedure utilize their own funds to so do)and Planned Parenthood also offers other critical components of sexual and reproductive health care. If Planned Parenthoods are unable to receive Medicaid reimbursements for these services, many would be forced to close. We’ve seen how defunding Planned Parenthood on the state level led to higher rates of unplanned pregnancies and already one unprecedented HIV outbreak. We also know that Planned Parenthood clinics are often the only full-service option for millions. This is especially the case for residents in states which did not expand Medicaid, as well as immigrants who are ineligible for coverage because of the clinics’ generous sliding fee scales. Don’t be fooled into believing other clinics would come even close to covering this gap. While the legislation would technically defund Planned Parenthood for one year at baseline, enough damage would be done by that year’s end.
It would leave even more people without abortion care coverage
Certainly, the ACA is a far cry from recognizing abortion as an important part of health care. If someone wants to purchase a plan covering the procedure, they must opt-in to tack the coverage on via a separate rider. Not only is this hardly transparent, but most people obtain abortions precisely because, well, they did not expect to become pregnant in the first place. Yet the new legislation is attempting to completely ban the use of tax credits towards purchasing plans which cover abortion beyond cases of rape, incest, and life endangerment. This strongly disincentivizes insurance companies from offering plans on the individual and small business employer marketplaces that provide comprehensive abortion care coverage. Not to mention that these efforts directly conflict with New York and California laws which mandate all insurance plans to provide such coverage, begging the question as to whether any residents of these states could utilize said tax credits meant to make plans more affordable. Additionally, the new plan would dismantle the ACA’s Medicaid expansion which is terrible in and of itself, though it’s also worth keeping in mind that all fifteen states where Medicaid covers abortion also opted to expand the program.
It would deeply cut Medicaid by introducing disastrous funding mechanisms
The subject of Medicaid funding is complex and occurs through several different avenues, though one important aspect is that states are guaranteed at least $1 in federal funds for each $1 of state spending. Trumpcare would replace this with a combination of funding via block grants and per capita caps. To break it down, block grants consist of a fixed amount that states may choose to allocate as they wish and per capita caps would limit spending to a fixed quantity per enrollee. Of course, neither could be altered in the face of rising health care costs and or unexpected needs like, say, another Hurricane Katrina or the HIV outbreak I mentioned above. It also doesn’t take into account how millions of people with disabilities reply on expensive, extensive, and life sustaining care which would likely be one of the first Medicaid services to be cut. This could force them into institutions, which states are required to cover in their Medicaid programs (unlike home and community-based care, which is optional). To add to the callousness, states which accept Medicaid block grants would no longer be required to cover family planning services and states could impose work requirements on enrollees, including people who have just given birth. Make no mistake, these measures would bring less flexibility to Medicaid, not more.
While efforts to stop such a cruel bill have been working so far, we are hardly out of the woods. Even if the Republicans in Congress don’t have the votes today or tomorrow or even for this go-around, they have made it clear they are dead set on dismantling the progress we have made under the ACA. As individuals who volunteer our time to fund abortions, we have plenty of stories to share — including our own — regarding how important comprehensive, affordable health care really is. Let’s keep up the pressure and keep telling our powerful stories! Have one to share? Email media(at)dcabortionfund.org.
by volunteer Meredith N.
There is no shortage of legislation aimed at eliminating abortion access for people in the United States. In fact, the number is growing. The most discussed in DC, arguably, is the Hyde Amendment—the legislation that bans the use of federal money for abortion except in the cases of rape, incest, or when the pregnant person’s life is in danger. Some states lessen the burden, which falls overwhelmingly on low-income people, by using their local Medicaid dollars to help pay for abortions.
Unfortunately, in DC, we also have the Dornan Amendment.
This month marks the sixth anniversary of the re-instatement of the Dornan Amendment, also known as the DC Medicaid Ban: the law stating that no congressionally-appropriated funds may pay for abortion in the District of Columbia.
Because Congress controls DC’s budget, the city does not have the autonomy to decide whether or not it wants to use its own locally raised Medicaid funds to help pay for abortions. And in a political climate that is increasingly hostile to abortion access, overturning the Dornan or Hyde Amendments seems unlikely.
At the DC Abortion Fund, we help low-income patients, many of whom are directly affected by the Dornan Amendment, pay for their abortions. In Fiscal Year 2016, 71 percent of our DC patients who reported their insurance provider said they were insured under DC Medicaid. This means they are faced with unjust coverage bans simply because their city is not permitted to control over its budget.
In Fiscal Year 2016, DCAF was able to fund over 1,300 patients, giving them the opportunity to access abortion services they may not have been able to afford otherwise. Because the Dornan Amendment affects so many people in DC, we see its toll on our budget. Many of these patients need to find additional funding that they would otherwise have from their Medicaid coverage, and money we give to one patient is money we cannot give to another.
DC may have fewer barriers to abortion than some states, however, even DC residents still face unjust burdens forced upon them by an anti-choice Congress.
Donating to DCAF helps us to alleviate some of the financial burden put upon DC residents by the Dornan Amendment. Your donation goes toward the patients who face an uphill battle when it comes to funding their right to choose.
The last few weeks have seen some surprisingly good news coming out of Virginia. In a win for reproductive justice advocates and patients, Governor Terry McAuliffe has vetoed a bill narrowly passed by the Senate that would have prevented the Virginia Department of Health from funding clinics that provide abortion services that would not be covered by Medicaid. This was the latest effort by Virginia legislators to defund women’s health clinics such as Planned Parenthood.
By vetoing this bill for a second year in a row, Governor McAuliffe is protecting the thousands of people who use Planned Parenthood for preventative health care, STD testing, birth control, breast exams, and a number of other vital health services.
Last week, the Virginia Senate also passed the Birth Control Access Act, which will require health insurance companies to cover a full year supply of birth control, rather than just a few months at a time. This is an enormous victory because barriers to contraception are a major factor in unintended pregnancies.
With a government that is expected to enact anti-choice policies in the coming years, we are happy to see support for reproductive rights coming through on the state level—especially in a state where we work to provide funding for abortion care.
On January 24, the U.S. House passed H.R. 7 to codify — and expand — the Hyde Amendment and related longstanding restrictions on federal funding for abortion. For the last four decades, the Hyde Amendment and other budget riders like it have created financial hurdles for abortion access for DC Abortion Fund’s Medicaid patients. Our patients who live in the District face an additional hurdle because of Congress’ constant meddling in DC’s budget — and sadly, that’s unlikely to change anytime soon.
The Hyde Amendment bans the use of federal money for abortion except in cases of rape, incest, or when the pregnant person’s life is in danger. Some states mitigate the effects of Hyde for their low-income residents by using their own funds to provide abortion access to people enrolled in Medicaid. But almost continuously since 1989, Congress has prohibited the District from using its own locally-raised Medicaid funds to pay for abortions through a rider known as the Dornan Amendment. (The ban was temporarily lifted in 1993, 1994, 2009, and 2010, but otherwise it has been in effect every year since 1989.) H.R. 7 converts these riders, which previously needed to be re-enacted every year, into permanent funding restrictions.
For many politicians and anti-choice advocates, DC residents are just another pawn in an ongoing effort to reverse the constitutional guarantee of abortion rights. It’s an easy “win” for them because the federal government exerts full control over DC’s budget while DC residents have no representation in Congress. Congress could not exert the same control over the residents of any other jurisdiction.
But for DCAF’s patients, this Medicaid ban is not just a move on a political chessboard.
When the Medicaid ban, also known as the Dornan Amendment, was suddenly reinstated in April 2011, DCAF saw “an immediate spike in need within our community,” and that need continues today, as DCAF board member Emily discussed on a recent episode of the Kojo Nnamdi Show.
In Fiscal Year 2016, 72 percent of our DC patients who reported their insurance type said they were insured under DC’s Medicaid program. The DC Medicaid ban stretches DCAF’s budget and forces many of our patients to scramble for funds that wouldn’t be needed if Medicaid covered abortion just like other medical procedures.
A first-trimester abortion can cost between $300 and $950. By comparison, the monthly income limit for an individual to be eligible for DC Medicaid is $2,128 — and that’s the upper limit, the maximum that a person can make and still be eligible for Medicaid. Many people make less than that, and when they can’t use their Medicaid coverage to pay for abortion, they often have to turn to family and friends who may also have a low income, pawn their belongings, consider which bills they can delay, or make other difficult choices.
In spite of all of this, we have a history in DCAF of turning rage into resilience. Our volunteers continue to take calls seven days a week, 52 weeks a year. In an ideal world, the Hyde Amendment — and all of its spinoff restrictions like the Dornan Amendment and H.R. 7 — would be history. We stand with our allies every day to try to make that world. And in the meantime, we keep answering the phone. Always.
By volunteer Deborah S.