The Business of Abortion

No doubt a number of priests across the country Sunday told their parishes to contact legislators and urge them to support an anti-abortion measure being offered in Washington.

With backing of the Catholic Bishops, Senator Ben Nelson, a conservative Democrat from Nebraska, plans to add an amendment to the health reform bill to make sure there's no expansion of federally funded abortions. As it stands now, federal Medicaid dollars pay for abortions only in the cases of rape, incest and when the mother's life is in jeopardy.

But Nelson wants to make sure anyone getting a health insurance subsidy from the government isn't turning around with our tax dollars and getting an abortion from a private insurer.

The question is how can anyone conclude that reform expands government payment for abortions?

Most insurance plans offered by Aetna Inc., Cigna Corp. and other major carriers, provide coverage for abortions. (In addition to surgical abortions, most insurers also cover the abortion pill.) Yet only about 13 percent of the more than 1 million annual abortions are billed to private insurers, according to a 2003 study by Guttmacher Institute.

Women usually don't know that insurance plans cover the procedure or don't want to submit claims, the institute says. Many abortion clinics aren't part of insurance networks and, therefore, don't bill the insurers, Guttmacher adds.

While the feds have strict limits on funding abortion (one of the most common medical procedures for women), at least 17 states (including California, New York and Illinois) use their own Medicaid funds to cover low-income women.

There is some precedent for government restricting private insurers from covering abortions, however. Idaho, Kentucky, Missouri, North Dakota and Oklahoma restrict private insurance coverage. Twelve states restrict abortion coverage for public employees and two of those states, Colorado and Kentucky, prohibit any public funds under any circumstance, Guttmacher reports.

There's also a shrinking base of abortion services in many of those smaller states. Almost 90 percent of the counties in the U.S. have no abortion provider. Women who live in the South or the Midwest are far more likely to live in a county without an abortion provider than those who live in the Northeast or West.

There is one constant: The cost of an early stage abortion has risen less than inflation, according to the National Abortion Federation. That group put the average cost at $350 for the procedure at an abortion clinic and $500 in a doctor's office.