News Law and Policy

Virginia Bill Would Abolish Abortion Funding for Low-income Women Carrying Totally Incapacitated Fetuses

Reilly Moore

A proposal in the Virginia General Assembly to eliminate state funding for certain abortions could force some low-income women to carry to term a fetus with a low likelihood of survival.

Published in partnership with The American Independent.

UPDATED, 3PM, January 17, 2013: This bill was defeated in committee this morning by an 8-7 vote. 

A proposal in the Virginia General Assembly to eliminate state funding for certain abortions could force some low-income women to carry to term a fetus with a low likelihood of survival.

Virginia State Senator Tom Garrett’s (R-Lynchburg) bill would repeal a provision of Virginia law that authorizes the Board of Health to pay for abortions for women who meet Medicaid eligibility requirements after a physician certifies that he or she believes “the fetus will be born with a gross and totally incapacitating physical deformity or with a gross and totally incapacitating mental deficiency.”

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Opponents of Garrett’s bill, including some Senate Democrats, argue that it would unduly burden low-income women economically, physically, and emotionally.

The number of abortions at issue is relatively small.

A total of 58 applications for state-funded abortions due to gross fetal abnormality were submitted between July 1, 2009, and Jan. 3, 2013, according to Virginia Department of Health statistics provided by deputy director of Family Health Services Lauri Kalanges.

Department of Health physicians review each application. The department approved 46 of those procedures—nearly 80 percent.

Kalanges told The American Independent in a phone interview that three physicians were involved with the completion and review of each application for funding.

First, a certified Virginia physician must complete and submit an application on behalf of the woman seeking the abortion, explaining his analysis of the fetal abnormality and his evaluation of the likelihood of survival.

Once submitted, two physicians employed by the Department of Health review the application, Kalanges said. Both physicians must agree that the fetus has a low chance of survival in order for funding to be approved.

“The review is based on diagnostic tests, medical evidence and the current available medical knowledge,” Kalanges said. “So it’s really on a case-by-case basis that through the review process, we determine whether there’s a low likelihood of survival for that fetus if born.”

Kalanges said there was no specific definition of a “gross and totally incapacitating physical deformity” or “a gross and totally incapacitating mental deficiency.”

“Some of the types of anomalies, either as a single area or in combination with other anomalies, lead to the decision that the fetus has a totally incapacitating abnormality,” Kalanges said. “That would be in the area of cerebral or brain deformities, cardiac heart deformities, certain types of chromosome abnormalities or other types of congenital abnormalities.”

Depending on the type of abnormality, Kalanges said, physicians consult medical literature to determine known survival rates for each diagnosis.

Kalanges said that physicians review each case independently and make their decisions based upon “records submitted and their interpretation given the known factors related to survival of the condition or conditions.”

Va. Delegate Jennifer McClellan (D-Richmond) said during a press conference in Richmond that Garrett’s bill represented the most offensive of numerous Republican-led efforts to restrict access to abortion in Virginia.

“You have wanted pregnancies with horrific results, when parents have to make the decision: Do I carry a child to term who may have their brain growing outside of their head, only so that when the cord is cut, that child will die?” she said.

McClellan said women approached her during the last legislative session to tell her they had unexpected abortions during planned pregnancies because of fetal abnormalities.

In a press release, Garrett said the bill would make Virginia law more consistent with the federal Hyde Amendment, which prohibits the use of taxpayer funds for abortions except in cases of rape, incest, or endangerment to the life of the mother.

The Hyde Amendment was first enacted by Congress in 1976. President Barack Obama agreed in 2010 to extend the principles of the Hyde Amendment to the Affordable Care Act.

The lack of coverage for fetal abnormality abortions in federal law makes Virginia’s provision even more important, McClellan said.

“If you have private health insurance and you make that decision [to have an abortion], that’s one thing,” she said. “If you’re on Medicaid or you’re a low-income person, you’re on your own.”

McClellan said she would fight efforts of anti-choice lobbyists and legislators to portray fetal abnormality abortions as issues of lifestyle convenience.

“Oftentimes [abortions] are the tragic end to a very much wanted pregnancy,” McClellan said. “Yet the legislators on the other side want to put them all into the same black and white box and legislate to the stereotype.”

Senator Garrett, through his legislative aide, declined multiple requests to be interviewed for this story. The Family Foundation, Virginia’s leading anti-abortion lobbying group, also did not respond to interview requests.

News Law and Policy

Virginia Bishops Use Medicaid Stalemate to Call for New Abortion Funding Restriction

Erin Matson

The bishops urge repealing a section in the Code of Virginia that provides state funding for abortions in the Medicaid program in the event of a gross and totally incapacitating physical deformity or mental deficiency in a fetus.

It’s a perfect storm for opponents of reproductive rights in Virginia: Democratic Gov. Terry McAuliffe has made Medicaid expansion his signature goal, house Republicans haven’t budged, and now the Virginia Catholic Conference says it supports expanding Medicaid—and that a new abortion funding restriction should be enacted.

In a statement issued Friday, four weeks into special session, the Diocese of Richmond Bishop Francis DiLorenzo and Diocese of Arlington Bishop Paul Loverde lent backhanded support to Medicaid expansion. “Our advocacy is informed by the Church’s teaching that, first, everyone has a right to life and second, that healthcare is a right,” they said.

The bishops urge repealing a section in the Code of Virginia that provides state funding for abortions in the Medicaid program in the event of a gross and totally incapacitating physical deformity or mental deficiency in a fetus.

Currently, Virginia Medicaid includes abortion coverage in four circumstances: life endangerment, rape, and incest is covered by federal Medicaid dollars; gross and totally incapacitating fetal impairment is covered by the commonwealth.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

In an interview with Rewire, NARAL Pro-Choice Virginia Executive Director Tarina Keene noted that the bishops’ statement argues for Medicaid expansion by expressing concern for the poor and vulnerable. Then, as she paraphrased it, it continued to say: “These pe ople, if they have a tragic pregnancy—screw them.” Keene said the commonwealth spent $13,058 to cover 14 abortions due to gross and totally incapacitating fetal impairment in 2013.

The bishops’ belated support for Medicaid expansion comes at a time when Virginia Democrats are grasping for negotiations. A special session began March 25 and Virginia Republicans have yet to relent on their opposition to Medicaid expansion. In response, hospitals have helped to lead the charge in lobbying them to soften their stance.

Joining this effort to lobby Republicans to expand Medicaid on behalf of the Virginia Hospital & Healthcare Association is Matt Cobb, a notable anti-choice official from the administration of former Gov. Bob McDonnell (R). In his capacity as a deputy health secretary, Cobb helped to lead the implementation and interpretation of an onerous clinic regulations law that has forced clinics to close. Cobb’s former boss Bill Hazel continues to serve as secretary of health under McAuliffe. These relationships, coupled with McAuliffe’s recent signing of a new conscience clause for genetic counselors into law, make the prospect of an abortion-related bargain not entirely out of the question.

As previously reported in Rewire, 400,000 low-income Virginians will gain access to health coverage if Medicaid is expanded. The senate budget includes a measure called “Marketplace Virginia” that would take advantage of the funding offered under the Affordable Care Act; the house budget does not. If a budget agreement is not reached by July 1 the government will shut down.

News Abortion

Virginia Legislators Want to Force Poor Women to Carry Severely Disabled Fetuses to Term Against Their Will

Robin Marty

If you want to avoid giving birth to a severely disabled fetus, you'd better hope you have money to pay for an abortion.

Poor women already face great disparities when it comes to accessing any health care, much less reproductive health care. Now, with a new bill being introduced by a Virginia state legislator, they will have to decide whether to desperately find money to access an abortion, or whether to risk their own health by carrying to term and giving birth to a fetus that a doctor has already stated will have little to no meaningful life outside the womb.

Via Laura Bassett at Huffington Post:

State Sen. Thomas A. Garrett (R-Lynchburg) has introduced a bill that would prevent Medicaid from subsidizing abortion services for low-income women in cases “in which a physician certifies … that the fetus would be born with a gross and totally incapacitating physical deformity or mental deficiency.” Women who currently receive Medicaid in Virginia have abortion coverage in cases of rape, incest, severe fetal abnormalities, or when the life of the mother is in danger.

Other anti-choice proposals being offered, such as insurance bans on abortion and contraception, or a bill to ban non-existent “sex or race selection” abortion, are disturbing on their own. Yet it’s the push to make women who use Medicaid into continuing medically-futile pregnancies or pregnancies that will result in a child with severe fetal anomalies that is the most disturbing.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Besides placing women at greater physical risk, the state would also be forcing her to spend overwhelming amounts of resources on a severely disabled baby for as long as it holds on to life, resources that are no doubt already scarce in the first place even if she has no other children and even more so if she is already a mother. Being pregnant and caring for other family members in the best of circumstances is a challenge. Being pregnant, poor, and possibly without another adult partner is even more difficult. There is no money to get a sitter, to rest, to take time off of work to care for a child or to rest if there are pregnancy complications.

Add to an already struggling family the additional severely disabled child to care for, which will have physical, emotional, and financial needs far beyond that of a normal newborn, and you have now created a completely unsustainable family situation. Who will stay at the hospital with the new baby and attend to its medical needs when there are other children at home to care for? How can a parent work? What provider or family member will care for a child with extremely expensive, intensive medical issues? How is a woman ever expected to be able to remove herself or her family from poverty with these additional burdens, and what does she do when the government continues to strip away all of the social supports under the guise of budget reductions?

There is no circumstance in which this does not greatly increase the obstacles placed on financially challenged women and their families. Instead, it’s simply an ideological exercise to force the one group of women who cannot say no into giving birth simply because anti-choice politicians want them to. Will the people of Virginia stand by and let that happen?