Virginia Denies Medicaid Funding for Abortion in Cases of “Substantial Endangerment”

Tarina Keene

Virginia's General Assembly revoked the rights of low-income women to Medicaid funding for abortion in cases where a pregnancy presents a “substantial endangerment” to their health. They claims its about money. It's not.

Maggie, a Class R diabetic and mother of two living in northern Virginia was devastated by the news. She was pregnant… again. Her first pregnancy resulted in complete bed rest at 16 weeks and she lost her eyesight. It took nearly a year – during which Maggie cared for both her newborn and her adopted son – for her sight to return. Doctors warned Maggie her body might not be able to endure another pregnancy; they mentioned the likelihood of a stroke, permanent blindness and other life altering ailments. After consulting with a team of medical professionals, Maggie and her husband chose to end the dangerous pregnancy. There were simply too many signs that another pregnancy would threaten Maggie’s ability to care for her children and maintain her health.

This April, Maggie’s traumatic story was shared on the floor of the Virginia General Assembly. Lawmakers shared stories of women with chronic conditions for whom pregnancy would severely jeopardize their health. They shared the stories that don’t usually make it into the public arena –the stories you only hear when a sister, a cousin, or a close friend has to face this kind of devastating choice. They were a stark reminder of a fact that’s easy to ignore: even in a country with highly developed medical technology, pregnancy is one of the most dangerous conditions a woman can face. In the end, it came down to just one vote on the Senate floor.

Nevertheless, despite hearing these accounts, 84 of the 140 members of the General Assembly revoked the previously-held right of low-income women to receive Medicaid reimbursement for an abortion if the pregnancy presents a “substantial endangerment” to their health. The reason for this change? To save the commonwealth a mere $150,000.  

This amendment is a huge set back for women in the commonwealth. Last year, 147 recipients of Medicaid received this subsidy to terminate pregnancies that would have substantially endangered their health. Going forward, these women will no longer qualify for this reimbursement, and will need to either find the funds independently or endure a dangerous pregnancy. Low-income women will bear the brunt of this callous act.

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The Governor’s Office insists this amendment will save the state money, but ultimately, the Virginia taxpayers will bear a far greater cost associated with these dangerous pregnancies. The true cost to taxpayers of a Medicaid recipient’s pregnancy, particularly if she has diabetes, cancer or another degenerative illness, far surpasses the cost of termination. In 2006, the commonwealth spent $227 million caring for Medicaid recipients with diabetes – a total of 12,000 hospitalizations. We assume that difficult pregnancies would increase total hospitalizations, driving up the associated expenses. If a diabetic like Maggie could not afford to terminate her pregnancy and carried it to term, the costs associated with her pregnancy and the related complications of her disease could easily reach $150,000 in a few years… even months. In the face of even one of these scenarios, the $150,000 savings begins to look like a drop in the proverbial bucket.

In addition, the broad language of the amendment suggests its repercussions could extend far beyond Medicaid recipients. The amendment specifies that “no general or non-general funds can be used to fund abortion.” The term “non-general funds” can apply to any monies flowing through the state’s university training hospitals, such as UVA in Charlottesville, MCV in Richmond, or EVMS in Norfolk. This means that women like Maggie, who seek care at a state-supported hospital, might see their procedures refused, even if recommended by their physicians. Additionally, state employees are bookended because state-sponsored health insurance will not cover any abortion and now a state hospital will not be able to address a critical situation. Surprisingly, we have yet to hear an opinion from our illustrious Attorney General Ken Cuccinelli – who is vehemently anti-choice – regarding these concerns. Without a doubt, despite his silence, he will find every possible way to make abortions less accessible in Virginia.

Let’s be clear. This is not about money. Considering the paltry savings associated with the amendment, it’s clear this decision reflects politics and ideology, not fiscal responsibility. This is about making decisions for women and their families without their input. This is about banning abortion by making it inaccessible – one reason, one woman at a time.

However, there is a way to turn this situation around. Because the governor’s amendment was made through the budget and not the legal code, we have the opportunity to change this disastrous policy during the next budget cycle.

For the Maggies of Virginia, there is no time to waste. We must all understand the implications this amendment has for the women of Virginia. Lawmakers may not be able to ban abortion entirely –but they can make it inaccessible. And that’s exactly what they are doing right now. Women must ask the governor, their delegates and their senators, “What sacrifices are you willing to make to save $150,000?”  The women of Virginia ask you to reconsider.

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