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Massachusetts Study: Health Care Reform Reduced Abortions

4 years ago
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A study published in the latest New England Journal of Medicine shows that abortion rates declined during the first two years that Massachusetts implemented a near-universal health coverage program much like the nationwide plan currently before Congress.

The research, which was released Wednesday, comes as the question of abortion is emerging as a pivotal factor in the Capitol Hill debate on overhauling health care. A cadre of anti-abortion House Democrats who could be critical to the bill's passage say provisions on abortion financing in the Senate bill are too weak.

That argument has come under sharp criticism from health care experts and ethicists in recent days. A growing number of Catholic leaders and organizations have also split with those Democratic opponents and the Catholic hierarchy, saying they believe the Senate bill does not allow for taxpayer money to underwrite abortions and therefore is worthy of support.

The latest to break with the bishops and support the bill is a coalition of Catholic nuns who head 60 religious orders representing tens of thousands of sisters, many of whom are directly involved in providing health care. A letter from the organization, a social justice association called NETWORK, was sent to all members of Congress on Wednesday and urges House members "to cast a life-affirming 'yes' vote when the Senate health care bill...comes to the floor of the House for a vote."

The sisters are emphatic in rejecting "false claims" that the Senate bill would finance abortion, and they -- like many others -- argue that enacting health care reform would save lives and support families.

The study on abortion rates released Wednesday could bolster that argument. It shows that the number of abortions in Massachusetts declined by 1.5 percent during the first two years of the new health care program (2007-2009) and the decline was 7.4 percent among teenagers -- even though the percentage of non-elderly people receiving coverage went up nearly 6 percent.

The study also points out that the abortion decrease occurred "despite public and private funding of abortion that is substantially more liberal than the provisions of the federal legislation currently under consideration by Congress." Massachusetts is one of 17 states where the state government finances abortions under Medicaid that the federal government cannot pay for.

The research project originated with Catholic Democrats, a pro-life organization affiliated with the Democratic Party, and was conducted by its president, Dr. Patrick Whelan, who serves on the pediatric faculty at Harvard Medical School and is a pediatric specialist at Massachusetts General Hospital for Children in Boston. Whelan also wrote the article for the New England Journal of Medicine, which reviewed it before publication.

Whelan notes that the declines fit in with an overall downward trend in the abortion rate in Massachusetts, though that decline has moderated in recent years. At the same time, however, the overall national abortion rate was increasing -- by 3.6 percent from 2005 to 2006, according to the latest nationwide data available.

As Whelan writes, "Complex social phenomena such as abortion rates are subject to a variety of political and social factors that are difficult to gauge."

"Yet," he concludes, "in this midsized, ethnically diverse state, full insurance coverage of abortion services for all lower-income residents did not result in an increase in the number of abortions performed."

"I believe it is reasonable to conclude that the possibility of some federal subsidization of overall care, for a fraction of the additional 31 million people who would be covered, would not mean a significant or even a likely increase in the number of abortions performed nationally."

In fact, the argument has often been made that universal access to good, affordable health care reduces the abortion rate.

"All the other advanced, free-market democracies provide health-care coverage for everybody. And all of them have lower rates of abortion than does the United States," T.R. Reid, author of "The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care," wrote in The Washington Post this week.

"To oppose expanded coverage in the name of restricting abortion gets things exactly backward. It's like saying you won't fix the broken furnace in a schoolhouse because you're against pneumonia. Nonsense! Fixing the furnace will reduce the rate of pneumonia. In the same way, expanding health-care coverage will reduce the rate of abortion."

Reid, a Catholic, went on to quote the late Cardinal Basil Hume of London, who Reid came to know when he worked there for The Post. Reid once asked Hume why the abortion rate was so much lower in Britain than in the United States even though abortion is free in the British health care system.

The most important reason the cardinal cited was the universal health care system. "If that frightened, unemployed 19-year-old knows that she and her child will have access to medical care whenever it's needed," Hume explained, "she's more likely to carry the baby to term. Isn't it obvious?"

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