Amid the circus that America's healthcare reform debate has become, the question of whether a public option should cover abortion often seems like little more than a particularly colorful sideshow. But it nonetheless remains a supremely divisive issue, as anti-choice Democrats refuse to support a plan that would use taxpayer money to pay for the procedure. And this is a moment when we can't afford to alienate potential allies.
So how do we find a solution that appeases everyone, without leaving women out in the cold? Last week, Slate's Meredith Simons proposed what appeared to be an attractive compromise: A private abortion fund, she argued, could provide for everyone who needed the procedure but couldn't pay for it. Women who needed abortions would get them, and anti-choicers who would otherwise support a public option would get on Obama's healthcare bandwagon. What's more, Simons did some calculations and figured out that it would cost about $311 million per year to cover abortions for women whose earnings are at or below 200 percent of the poverty line. And, she discovered, private donors already give roughly $250 million yearly to support "abortion issues." So, Simons concluded, we're almost there. A little extra spending on contraception here, a dash of extra support from those who are upset to see the government plan exclude abortion, and all low-income women in America would be covered. Of course, her article made a major splash on the Web, as everyone from Amy Sullivan at Time magazine's Swampland blog to Steven Waldman, editor-in-chief of BeliefNet, picked it up.
But if Simons' proposal sounds too good to be true, well, that's because it is. On Friday, a major correction appeared at the bottom of the page. (Those who are looking for the original, uncorrected piece can still find it at Double X.*) According to Slate, the "article originally implied that researchers at the Guttmacher Institute said providing abortions for every woman in the United States would cost about $500 million a year. This was the author's calculation, based on Guttmacher data on the average cost of an abortion ($413) and the yearly number of abortions performed in the United States, both total and for poor women. The extrapolation of a total cost of $311 million to cover abortions for poor women was also the author's, not Guttmacher's." Tuesday's update saw an even bigger correction. It turns out that the $250 million figure Simons quoted was also misleading: That number refers to the total amount of money private donors gave to support "abortion issues" -- nationally and internationally. As Slate discovered, only about $63.7 million actually goes to support abortion domestically.
This figure alone -- combined with the fact that Guttmacher isn't actually backing up her estimates -- kills Simons' argument. But in the edited version of her piece, she argues that "a reallocation of funds from international groups to American groups" is still a viable option for realizing her plan. I don't think I have to explain how devastating this would be to reproductive rights worldwide, considering the number of countries that are still decades behind the U.S. in offering safe, legal abortion services.
Meanwhile, I have to wonder if that $63.7 million figure breaks down even further. Shouldn't donations marked as supporting "abortion issues" -- rather than "abortion procedures" -- also include funding for advocacy organizations such as NARAL Pro-Choice America? Would we really want to "reallocate" the money that's going to groups committed to keeping choice legal? And what about the portion of the funds that actually are already reaching private abortion funds? In addition to the cost of the abortions themselves, these organizations have to pay full-time staff members, rent office space, buy supplies, pay electricity bills, and so on. Unless I'm misreading Simons' article, none of these considerations figure into her estimate.
Now, I can speculate and poke holes all I want, but it's Erin Kate Ryan, Communications and Development Director for the National Network of Abortion Funds (NNAF), who provides the real reality check. According to Ryan, Simons interviewed NNAF for her article but didn't include their input in the published piece. (In fact, the organization isn't even mentioned.) It's a strange oversight, since the group, which was founded in 1993 and includes 104 private abortion funds in North America and the U.K., already does what Simons is proposing.
The figures Ryan provides justify my worst fears about how much private money is actually going to fund abortions for women who can't afford them: The NNAF -- which is the only network of its kind in the U.S. -- and its member funds raised and distributed $2.6 million last year. While their efforts have been enormous and heroic, they realize that they can never help as many women as need to be helped. In 2008, they paid for or subsidized 21,000 abortions. But, as Ryan writes, that falls woefully short of meeting the needs of all American women who can't pay for their abortion:
The Network can tell you definitively: no private abortion fund can ever replace public funding for abortion. Conservative estimates tell us that more than 100,000 women need help paying for their abortions each year. Existing abortion funds, despite their commitment to abortion access for all women and families, are not able to meet this need now. If healthcare reform were to exclude abortion coverage, millions more women would stand to lose the coverage they have, placing them at the mercy of an already over-burdened private system – one, like all other areas of the private sector, that has been subject to the recession’s deleterious effect on well-resourced and well-meaning funders and donors. [See this post for more on the implications of excluding abortion from the public option for women who would use government funds to subsidize their private health plans.]
The women and men who run our member funds do so because they believe that all women have a right to access the abortion care they seek. These member funds act with kindness and compassion and endeavor to treat every woman with dignity; even so, there is no question that women seeking abortion funding face an increased emotional burden. They make dozens of phone calls, sell their belongings, live without electricity – all so that they can access a basic medical procedure that someone else’s politics have placed outside their reach. Is this really the future we want to advocate for millions more women?
Ryan's conclusion, divisive and difficult though it may be, is nonetheless essential: "If our society is going to redress decades of unequal treatment through health care reform," she writes, "then our conversations must be rooted in these families’ experiences, not dismissive of them."
* UPDATE: After Broadsheet's post was published, Double X replaced Simons' original piece with a new, corrected version.