Hey Senator Kyl, GOP: Nice Family Values (NOT!)

Have you heard about the (fortunately now failed) amendment to health care reform that directly affected maternity care? Or read Senator Kyl's now infamous statement and Senator Stabenow's classic rebuttal? If not, check out Karoli's summary and take on it.

Insurance loved Kyl's position, of course.“The point of insurance is to insure against catastrophic care costs. That’s what you’re trying to aggregate and pool for such things as heart attacks and cancer,” said an Anthem Blue Cross spokesman. “Having a child is a matter of choice. Dealing with an adult onset illness, such as diabetes, heart disease. breast or prostate cancer, is not a matter of choice.”

As much as it pains me deeply at this precise moment to just let the "choice" discussion slide (and the point that diseases deserve to be treated but not pregnancy) -- for now -- I will to make a larger point. Unfortunately, Kyl's position (and the insurance industry's position) is a horrifically short-sighted view on the cost of maternity care. When maternity care is excluded, it can become a catastrophic event for families. That can lead to sicker mothers (more costly), sicker babies (more costly), and even tougher choices. When women lack the financial resources and health care to manage a pregnancy and child, they are more likely to abort or adopt out the baby.

With the downturn in the economy, unemployment and lack of insurance is on the rise. Six in ten Americans receive health insurance through their employers, and once that employment comes to an end, they join the rising numbers of uninsured Americans.

"Employers have shed 5.1 million jobs in the last 15 months," according to American Progress, "We estimate that 2.4 million workers have lost the health coverage their jobs provided since the start of the recession, based on data from the U.S. Census Bureau and the Bureau of Labor Statistics. Approximately, 1.3 million of these losses have occurred in the last four months."

Further, according to Medical News Today, "The number of uninsured U.S. residents could increase from about 45 million people this year to 54 million people in 2019 unless the lawmakers change federal health care policy, Congressional Budget Office Director Douglas Elmendorf said."

With statistics like that, fear of losing jobs, and rises in costs, many Americans are cutting back as much as possible. But when a pregnancy happens -- especially if it is unplanned -- it can be a devastating event, especially if a family or woman is already feeling vulnerable and living paycheck to paycheck. It can be catastrophic if they lack health insurance.

USA Today says that at least six of the largest adoption agencies in the US are reporting a climb in the number of people placing children for adoption. According to spokespeople for the adoption agencies USA Today interviewed:

"Many of these women are in their 20s and already have at least one child,” says Joan Jaeger of The Cradle, the Chicago-area agency that placed Joie. She says 30% more women are inquiring about placing a child for adoption than a year ago.

“The economy has made them take a second look at adoption," says Scott Mars of American Adoptions, a private agency in Overland Park, Kan.

In the past year, he's seen a 10% to 12% increase in women inquiring about placing a child for adoption and a 7% to 10% increase in actual placements, as strong demand for healthy infants continues to outstrip the supply.

"We've seen a dramatic increase in girls calling us from the hospital," says Joseph Sica of Adoption By Shepherd Care, an agency in Hollywood, Fla.

He says they expect to get help to raise their children, so they wait, but after they give birth and no help arrives, they call. He had 14 such adoptions in 2008, up from 11 in 2007 and four in 2006.

"Finances are one of the major reasons women feel compelled to place their children for adoption," says Adam Pertman of the Evan B. Donaldson Adoption Institute, a research group."

Renee's Siegfort's moving story of deciding to place her baby in an adoptive family demonstrates exactly how much finances affect a woman’s decision. Siegfort, 36, has three teens, and works full-time. She says her family lives simply, and, though she and her children wanted the baby, her boyfriend did not, and she did not see how she could provide well for all three of her children plus the new baby. After careful consideration, Siegfort met with a prospective adoptive family, and it was a great fit for all. She says, in her video interview, that it is the hardest thing she's ever done, but there has been much joy, too. She also says that she is sure it has been the right decision for everyone in her case. Her children, although they admit they had mixed feelings at first, agreed.

Additionally, adoption enabled Siegfort to provide health care for her developing baby, because her job doesn't provide health insurance. Since she already struggles financially, adding in the burden of additional health care, especially costly prenatal care, was infeasible.

She is pro-choice, but selected adoption over abortion because it seemed like the best decision for her. Other women are choosing abortion---in climbing numbers. According to USA Today, "Vicki Saporta of the National Abortion Federation, which represents abortion providers. . .says calls to her group's hotline have nearly tripled in the past year, many from women whose families have lost jobs."

Many other families are delaying adding to their families until the economy recovers. The Los Angeles Times reports:

As the economy worsens, some Planned Parenthood clinics are reporting a record number of abortions. Other women's health agencies say they are experiencing heavier call volumes, more visits and more requests for abortion funding. In addition, many women are postponing pregnancy and switching to longer-term contraceptives that can last up to five or 10 years, clinic officials report.

All of these choices are people making responsible, well-thought through decisions that they determine are best for all involved.

But are they the choices people want to make? Do people -- without insurance or without insurance that covers maternity -- really have the ability to choose?

Only 14 states require that maternity care be included in health benefits policies, which means many women in the majority of states might be left uncovered by insurance, and unable to access adequate health care. If they happen to be over the income cutoff, they are out of luck for being able to receive any assistance, as it stands currently -- the status quo Kyl would have liked to maintain, and spread to all 50 states instead of just the 36 that currently allow maternity to be excluded.

I live in one of the 36 states that allows maternity to be excluded. I had no idea it was even possible to exclude maternity coverage -- who would even think you could, or would? However, when my family and I moved to Texas, I was four months pregnant. For a couple of months, I maintained my insurance through my employer in Massachusetts with no problem. When we needed to move me to my husband's plan, we discovered that my pregnancy was excluded and I could not receive any health care.

We researched the cost of appointments, tests, and other necessary care for my pregnancy, as well as the cost of labor and delivery, and the total cost -- if nothing went wrong -- was beyond our means. We were devastated. Even more devastating, the pregnancy was not trouble-free and not only did I end up hospitalized briefly, and then on bed rest with frequent check-ups, but I also contracted antibiotic resistant atypical pneumonia in the hospital. Our health care costs went up well into the five digits -- exceeding my husband's annual income.

Luckily, we had decided to pay through the nose for a COBRA plan from Massachusetts. So we ended up just financially hurt and in some debt versus homeless. . .or worse.

What's worse? Without that health insurance I might not have decided to pay attention to the pain I was in and go see my OB-GYN. I might not have agreed to run to the hospital for a quick check. I might not have gotten the scan to diagnose the pneumonia. We caught things early and did necessary early intervention so things were just worrisome versus catastrophic.

We were able to make that choice because we had the COBRA plan.

I wish, though, that we had been able to simply have a regular, affordable health insurance policy that covered the maternity care.

I realize that this creates some more "risk" for the pool that might slightly raise the potential cost, but I've never begrudged covering diabetes or lung cancer treatments for people, or even Viagra for men. And technically, we can argue that sometimes, lifestyle choices are behind some of those conditions. (Rear back, I'm not agreeing with that or ladling judgment; simply pointing out the ineffectiveness of that argument or how easily it can be reapplied to something that affects you, or even Senator Kyl.)

So stepping away from my own sob story, let's look at the general American public and this issue. Many female single parent families who are below the poverty line (for a single parent family with two children, that point is $18, 310/annually) can qualify for public health care assistance, but families such as Siegfort’s that are above the poverty line at or near the median for annual full-time women’s income of $34,278, if they can’t get insurance through an employers, then health care (premiums, deductibles, and co-pays) can exceed their budget completely, if they want food, clothing and shelter, too. Even two parent families in the low to middle income levels can struggle to provide health care insurance for themselves and their children. In 2006, 45% of women were uninsured, and on average 1 in 9 children are uninsured. That number has climbed, according to American Progress, which stated that over 1 million lost health insurance in the first three months of 2009, not counting spouses and children who also lost insurance if they were dependents.

"The cost of health insurance premiums is rising 10 times faster than the median American salary, making it nearly impossible for many families to pay for health insurance and still stay afloat," said American College of Obstetricians and Gynecologists President Douglas H. Kirkpatrick, MD, "Every American deserves a chance at living a long and healthy life, and having medical insurance is crucial to achieving that.”

If Americans can barely afford medical insurance, and 80% of women will have a child in their lifetime, and if the majority of medical plans can exclude maternity -- what do you think that means? Where does that leave women and their babies? In the cold.

Medical insurance is crucial to a pregnant woman. Without it, she will not be able to access all of the necessary pre-natal and post-natal care to ensure her and the baby’s best health. The White Ribbon Alliance--an international coalition bound together by a common goal: to ensure that pregnancy and childbirth are safe for all women and newborns in every country around the world---recently launched their Every Day is Mother's Day campaign to spotlight the need to care for pregnant women, new mothers and babies, "Every minute of every day, a woman dies of pregnancy related complications, totaling more than one half million women each year," their site states.

Not only does this lack create health risks for women and children, it creates a financial burden on the system. After an extremely interesting study and analysis of data, American Progress concluded that

"The rapid loss of health coverage demonstrates the fundamental instability of health insurance protections in our current system and the need for comprehensive health reform. As President Barack Obama asserted in a White House forum in March, “Health care reform is no longer just a moral imperative, it is a fiscal imperative… If we want to create jobs and rebuild our economy, then we must address the crushing cost of healthcare this year, in this administration.”

Fortunately, their same study demonstrated that, "Sixty-two percent of the American public believes that the current economic turmoil makes it more important than ever to take on health care reform."

That health care reform needs to allow women who plan to have children or who are pregnant to access proper care, but it also needs to allow for women to retain access to all their legal reproductive choices.

Daily Women's Health Policy report states that, "Chuck Johnson -- chief operating officer of the advocacy group the National Council for Adoption -- said that the percentage of women who place a child for adoption remains low overall, which he attributed to access to legal abortion and greater societal acceptance of single parenthood."

Without health insurance and access to health care, women are not truly able to select the choice that is best for them. Financial imperatives may force women into choices they don't prefer---whether that means not getting appropriate prenatal care, opting to abort because they fear they can't financially manage a pregnancy, or adopting out a baby because they can't provide for the child. All of these choices are open to women, and they are legally free to choose which is best for them personally. Unfortunately, that freedom is an ideal and thus theoretical freedom; financial constraints and lack of access to health care a woman can afford create an obstacle to all choices equally.

Therefore, let's insure women to ensure that they are making the overall best choice, not feeling forced into one due to finances or lack of access to health care or coverage of women's health.

Comments

[Karoli]

What you said. And then, there's this: The maternity care issue strongly discourages women from choosing to be self-employed in cases where they cannot get coverage through their spouse's employer (such as my case, where both my spouse and I were self-employed). You would think Republicans would understand how this squelches entrepreneurship and business initiative.

You would think. Once again, they demonstrate that they're for small business until they're against it.