as a representative Liana Casa (Democratic, District 66, Barrington, East Providence) introduced Abortion Insurance Equality Act, her legislation to remove the abortion insurance ban that currently exists in Rhode Island’s Medicaid and state health insurance plans, makes a powerful and profound case. Here are her words, in full text.
“I’m here to introduce H7442, the Abortion Insurance Equity Act, which would remove the abortion insurance ban that currently exists in Rhode Island’s Medicaid and state health insurance plans. It is an invasion of privacy and an invasion of personal liberty for the government to decide if and when a person becomes pregnant, gives birth and parenthood.
“Removing the abortion ban in our state ensures that necessary health care is provided when patients need it, no matter how they pay for it. Pregnancy is not a benign condition, nor is it a health-neutral event. Pregnancy can and often is physically and financially difficult. Childbirth can and often is physical and financial hardship. It can and often is physical hardship. It is always a long-term financial commitment, and for some, Rhode Island parents a daunting task.
“We are not providing enough support for parents, pregnant women and parenting. We don’t have enough paid parental leave and we don’t have enough sick leave. We don’t have enough mental health services for people with postpartum depression, and we don’t have enough early intervention services. We are not providing adequate support for parents with disabilities, nor for parents raising children with disabilities. We don’t have enough affordable child care, and we don’t have enough affordable housing. We lack the social service infrastructure to help families succeed, especially those with the lowest incomes.
“However, we do have more and more families experiencing hunger and homelessness. The lack of access to abortion has pushed people already marginalized by our struggling health care and social services systems to the edge. Pregnancy, childbirth, childbirth and parenting are a potential life sentence for individuals trapped in households with domestic violence. Even under the best medical conditions, pregnancy, childbirth, childbirth and postpartum can have direct effects on the body. Childbirth and adoption are not reasonable alternatives to abortion.
“Pregnancy can have long-term adverse health effects and often pose risks to the life and health of pregnant women. Maternal mortality rates have been rising in the U.S. and Rhode Island for the past 20 years, with blacks, browns, and the poor having the highest rates. In the public health community, black and Hispanic women are several times more likely to die in childbirth than their white peers, data show. Maternal mortality is an indicator of general population health. The historically rising rate when we have access to quality health care should shock us all and call for action across the country and in Rhode Island.
“In addition, there is a high rate of maternal morbidity, short-term and long-term complications of childbirth. Black, brown, and poor Rhode Islanders have higher rates of maternal morbidity and are more likely to be readmitted for postpartum pregnancy-related complications. With more than 60% of abortionists being parents, we can imagine the stress on a family, not to mention childcare costs, when a person needs to be readmitted after birth if they are going through physical birth constraints that prevent them from caring for their family Even the ability to return to work.
“That’s one of the many reasons why individuals, not us legislators, should decide whether or not they have children. Getting health coverage through Medicaid or a state health insurance program is not an option, but a condition of individuals’ economic realities beyond their control— —Abortion cannot be performed through Medicaid or state health insurance plans.
“The lack of access to abortion is not the result of market forces. It’s the result of a handful of lawmakers deciding that their beliefs should control the lives and health care choices of individuals enrolled in Medicaid and state programs. In addition to removing individuals from agency over their own bodies, restrictions on access to abortion insurance can also affect our healthcare providers’ ability to provide quality care.
“Our state’s OB/GYNs are among the best healthcare providers in the country. They are highly trained, board-certified clinicians who work tirelessly to ensure the health and well-being of their patients. They are dedicated to advancing women’s healthcare through continuing medical education and through practice, research, and advocacy for patients. They work hard to ensure the best possible health outcomes, and they understand that in some cases, patients will not be able to continue their pregnancy due to personal financial and medical reasons.
“Abortion bans, like our current bans, tie the hands of these medical professionals in the event of fetal death or miscarriage or miscarriage where abortion is medically necessary. If a patient is covered by Medicaid or a state health plan, the provider is limited in the services they can provide or access on behalf of the patient.
“In this case, the beliefs of complete strangers, in this case, the few lawmakers opposed to abortion in this building without insight or consideration of the medical realities faced by physicians and patients, entered the examination room and limited options . In such cases, care is often delayed to determine how to pay for services not covered by insurance. In the case of pregnancy complications, any delay increases health risks. That’s a reality for Rhode Islanders who get health insurance through Medicaid. By definition, those poor people — and 33,000 people, like those of us who work in this building and our family members, are covered by the National Health Insurance Plan.
“I urge my colleagues to resist the temptation to insert the beliefs of a few legislators into the examination rooms of large numbers of health care providers and their patients. Pregnancy has significantly life-changing and sometimes life-threatening effects, as well as significant life-changing financial consequences.
“It has to be in the hands of individuals to determine if they are ready and able to go ahead with a pregnancy. As a state, we don’t make it easy for people to have children, and the legislature cannot accept the reproductive lives of individuals in Medicaid and state programs because we Yes, and because a handful of legislators think we should. I believe deeply and wholeheartedly that women and others make their own medical choices for themselves. When making their own decisions, they should be covered by men in their health insurance plans and the freedom that individuals currently enjoy. I have great confidence in Rhode Island’s health care providers to care for their patients and provide the highest quality reproductive health services.
“Maintaining the abortion ban is not good economic policy, it is not good health policy, and it is not good for Rhode Island. Fortunately, the General Assembly has resolved the question of whether abortion will still be available in Rhode Island in 2019. Now we just need to achieve the right rights for all Rhode Islanders, no matter how they pay for their health care.
“I urge this committee to vote down the bill and send it to the House so we can ensure abortion is accessible to all.
