Should There Be Federal Funding For Abortions?
February 6, 2013.
Social Work 7065: Foundation Macro Theory and Practice
Instructor: Mr. Robert Graham
SHOULD THERE BE FEDERAL FUNDING FOR ABORTIONS?
History of the Abortion Controversy The abortion controversy began after 1973 when the use of public funds was used to pay for abortions. Some “anti-abortion partisans expressed outrage that their tax money was being used in support of a procedure that they viewed as murder, and strong efforts were made to forbid the expenditure of public …show more content…
funds for abortion” (Rodman, Sarvis, Bonar, 1987, p. 115). Federal legislation was created to “prohibit the use of foreign aid money to support abortion and to prohibit lawyers who worked with the Legal Services Corporation from helping any clients receive an abortion” (Rodman, Sarvis, Bonar, 1987, p.115). The critical area of controversy was over the Medicaid program, Title XIX of the Social Security Act. It “provided federal matching funds to the states for the medical care of poor women” (Rodman, Sarvis, Bonar, 1987, p.115). In 1976, “about $45 million in federal Medicaid funds helped to pay for more than 250,000 abortions” (Rodman, Sarvis, Bonar, 1987, p.115). This huge number of abortions represented “more than 25 percent of all the abortions in the United States during this particular year” (Rodman, Sarvis, Bonar, 1987, p. 115). The most important question that the courts had to gather more information about was whether the “Constitution or the federal Medicaid Law required state or federal government to provide free abortions to medically poor women” (Rodman, Sarvis, Bonar, 1987, p.115).
SHOULD THERE BE FEDERAL FUNDING FOR ABORTIONS? Under the Medicaid program, the states had to follow the requirements of federal law to be eligible for federal funds. “Some states tried to restrict funding under the Medicaid program to medically necessary abortions. A federal court found that such a restriction, in Pennsylvania, did not abide by the federal Medicaid law. That law passed in 1965, called for a state plan with “reasonable standards” to determine eligibility for medical assistance” (Rodman, Sarvis, Bonar, 1987, p.115). The “United States Supreme Court held the restriction in the Pennsylvania Law, in Beal vs. Doe, which was decided in 1977” (Rodman, Sarvis, Bonar, 1987, p. 115). The court ruled that “restricting the state plan to medically necessary abortions was reasonable and in compliance with federal law” (Rodman, Sarvis, Bonar, 1987, p.115). This law provided options for states to make their own decisions to include or exclude coverage for elective abortions.
SHOULD THERE BE FEDERAL FUNDING FOR ABORTIONS?
Pros on Abortion The first argument that should be examined, is there an effect on Medicaid abortion funding restrictions on fertility outcomes in the United States? There is professional literature that suggests “following the Roe vs. Wade decision, the Medicaid system, provided health insurance for certain low-income individuals, paid for all abortions performed on women who had medical coverage” (Levine, Trainor, Zimmerman, 1996, p.556). These payments were eventually “eliminated in many states in response to a 1980 Supreme Court decision” (Levine, Trainor, Zimmerman, p.556). To examine the impact of these restrictions, the research examined “state-level data on abortions and births over a 12 year period” (Levine, Trainor, Zimmerman, 1996, p.556). The findings suggest that “funding restrictions reduce the rate of abortion and either reduce or have no significant effect on birth rates” (Levine, Trainor, Zimmerman, 1996, p.556). These results show that the “fraction of women who became pregnant also declined in their response to the restrictions” (Levine, Trainor, Zimmerman, 1996, p.556). There was state level data that was taken from “1977-1988 that found funding restrictions reduce the number of abortions performed” (Levine, Trainor, Zimmerman, 1996, p.575). For “abortions to go down and births to be either unaffected or reduced, it is likely to be the case that pregnancies are reduced as well” (Levine, Trainor, Zimmerman, p. 575). These findings are supported in the
“National Longitudinal Survey of Youth (NLSY) data and additional results indicate that the behavioral effects of funding restrictions are focused among women who live below the poverty line” (Levine, Trainor, Zimmerman, 1996, p.575).
SHOULD THERE BE FEDERAL FUNDING FOR ABORTIONS?
Article Critique
In the previous article with Levine, Trainor, Zimmerman (1996), they did a good job explaining how Medicaid has restrictions on abortion and how fertility rates in Michigan have decreased. This is an excellent point to make because it shows that women are making better choices by using contraceptives to keep fertility rates low.
SHOULD THERE BE FEDERAL FUNDING FOR ABORTIONS?
Cons on Abortion The second argument that needs to be further researched is the explanation of the Hyde Amendment and what does it cover? The Hyde Amendment “was passed in 1976 and has been re-approved every year” (Dennis, Blanchard, 2013 p.237). Currently, “federal funds can only be used to cover abortion when the pregnancy is a result of rape or incest, or threatens the life of the woman (here-after referred to as Hyde-qualifying cases” (Dennis, Blanchard, 2013, p.237). There are “Thirty-two states and the District of Columbia that follow the federal example and restrict the use of Medicaid funds to Hyde-qualifying cases” (Dennis, Blanchard, 2013, p.237). “South Dakota violates the federal law, because it only covers abortion when a woman’s life is endangered” (Dennis, Blanchard, 2013, p.237). “Seventeen states use their own funds to cover all or most abortions” (Dennis, Blanchard, 2013, p. 237). This study found that “poor state-level implementation of Medicaid coverage of abortion policies creates barriers for women seeking abortion” (Dennis, Blanchard, 2013, p.237). Efforts to “ensure policies are implemented appropriately would improve women’s health” (Dennis, Blanchard, 2013, p.236).
Article Critique In the Dennis, Blanchard, (2013) article, there should have been research done to support why the seventeen states mentioned, use their own funds to pay for most or all of the abortion costs. Also, the article did not discuss how these states paid for abortion.Suprisingly, the article did not examine why Medicaid was not being utilized in seventeen states.
SHOULD THERE BE FEDERAL FUNDING FOR ABORTIONS?
Pros on Abortion The third argument that should be addressed, is how does the restriction on abortion laws focus on how data that was taken over the years in 1982, 1992, and 2000 were taken to estimate the impact that the price of an abortion and various restrictive abortion laws have on the demand for abortion in the United States? The results show that” Medicaid funding restrictions of abortion and parental involvement decrease both the average state abortion rate and the average state abortion ratio as compared to states without these laws” (Medoff, 2008, p.344). A state waiting period and a mandatory counseling law have no statistically significant impact on the demand for abortion. These results “suggest that a waiting period law and a mandatory counseling law represent an increase in the effective total cost to a woman obtaining an abortion (Medoff, 2008, p.344). Medicaid funding “restrictions of abortion, and parental involvement laws cause a greater reduction in the average state abortion rate than on the average state abortion ratio” (Medoff, 2008, p. 344). This research is “consistent with the hypothesis that increases in abortion costs not only reduce the number of abortions, but also reduce the number of pregnancies by altering women’s sexual contraceptive practices” (Medoff, 2008, p. 329).
SHOULD THERE BE FEDERAL FUNDING FOR ABORTIONS?
Article Critique The Medoff (2008) article did a great job explaining how abortion costs are restricted through Medicaid funding and because of this, women are having fewer abortions and women are having fewer pregnancies. This data may suggest women are realizing that abortion can be very expensive, and since Medicaid doesn’t cover the procedure unless she has been raped or in an incest situation, women make better choices about sex and using contraceptives.
SHOULD THERE BE FEDERAL FUNDING FOR ABORTIONS?
Cons on Abortion The fourth argument that needs to be addressed is the explanation of why women who decide to have an abortion; usually pay for it out of pocket? “Most states do not allow for public funding, Medicaid support or even private insurance coverage for elective abortions, so the high cost of abortion services alone limits access for vulnerable groups of women” (Ely, Dulmus, 2010, p.664). The Hyde Amendment of 1977 mandates that “state Medicaid programs cannot cover elective abortion services, although it requires coverage in cases of threat to the life of the mother, rape, and incest” (Ely, Dulmus, 2010, p.664). What is rarely discussed is that a woman must “file a police report to be eligible for coverage for rape or incest, a process that many victims do not have the empowerment to proceed through, as paperwork is burdensome and rehashing the crimes can be humiliating and debilitating” (Ely, Dulmus, 2010, p. 665). “After the victim takes the time to file a police report, coverage for abortion under Medicaid is almost always denied” (Ely, Dulmus, 2010, p. 665). It is also difficult for physicians to “diagnose with certainty that a condition endangers the life of the mother, as medical science is not exact, and many women are told such things as they “might” be at risk” (Ely, Dulmus, 2010, p. 665). Evidence suggests that poor ”women often pay for abortions with money that was supposed to be used for food or rent; they have trouble getting money together, resulting in later-term and more costly abortions; or they cannot afford the abortion are left only with the option of forced pregnancy” (Ely, Dulmus, 2010, p.665). The professional literature estimates that “one in three women on Medicaid would choose abortion if
SHOULD THERE BE FEDERAL FUNDING FOR ABORTIONS? coverage were provided but instead continue a pregnancy to term against their will, as they feel it is their only choice” (Ely, Dulmus, 2010, p.665).
Article Critique The Ely, Dulmus (2010), article made an excellent point about poor women not being able to afford abortions and taking their money for food, rent, etc to pay for the procedure to get done. Poor women may not want anyone to know that they are pregnant and they would rather pay for the procedure themselves, than to hear the negative opinions from parents, friends, or relatives.
Pros on Abortion The fifth argument focuses on teen pregnancy. There is an article that discussed new evidence about the policy effects of restrictive state abortion laws on teen pregnancy. The data from this study indicate that the “price of abortion, Medicaid funding restrictions, and an informed consent law all reduce their frequency of unprotected sexual activity or increasing their use of contraceptives resulting in fewer unwanted teen pregnancies” (Medoff, 2010, p. 188). This study examined pregnancy rates of teens between the ages of 15-17. This information implies that teens respond to public policies that increase the cost of an abortion by increasing their level of pregnancy avoidance” (Medoff, 2010, p.188).
Article Critique The Medoff (2010) article did a good job explaining how teen pregnancy between the ages of 15-17 has a positive effect on abortion rates and pregnancy rates. This data suggests that teens are making better choices regarding sex and using contraceptives to prevent pregnancy..
SHOULD THERE BE FEDERAL FUNDING FOR ABORTIONS?
Cons on the Able-bodied Poor In the Hasenfeld article (2000), it discussed how welfare departments have changed, but certain features have remained the same about the “able-bodied poor” (p.348). According to this article, these “type of people are viewed as deviants and “others”; ensuring that the giving of aid will not corrode the work ethic; and upholding the moral code about family values, gender, and ethnicity by degrading the poor” (Hasenfeld, 2000, p.348). Even though welfare departments have specific departments that handle different issues, they will always use their client’s status of being poor as a guide to stereotype them. (Hasenfeld, 2000, p.349).
Article Critique The Hasenfield article relates to the abortion controversy because during the debate, the discussion has been on poor women receiving assistance from Medicaid to pay for abortions. This article discriminated against poor people who are able to do for themselves. People who receive public assistance should be treated fairly without discrimination. There are many different economic factors that the article did not address that can affect a person being poor like unemployment, education, lack of resources, or mental health issues. More research needs to be conducted on this study for it to be effective.
SHOULD THERE BE FEDERAL FUNDING FOR ABORTIONS?
Pros on Abortion The sixth question is has the Roe vs. Wade decision shown a positive effect on abortion? The Roe vs. Wade decision examined how “pro-life advocates have focused their energies, lobbying efforts and campaigns toward congress and in state legislatures” (Taylor, 1998, p.12). As a result, abortions are legal, yet restricted on a number of levels. These “statutory restrictions as well as other factors including education, family planning, and birth control methods have contributed to a decline in the number of abortions over the years” (Taylor, 1998, p.12). According to the “Michigan Department of Community Health figures, abortions in Michigan have declined from 45,455 in 1980 to 30, 208 in 1996” (Taylor, 1998), p.12).
Book Critique The previous article by Taylor (1996) provided some key information about the abortion rates in Michigan. This is a huge accomplishment. This data shows that women are using more contraceptives to prevent pregnancy. Women have so many resources for family planning services, contraceptives, sex education, birth control pills, morning after pill, etc. to lower pregnancy rates in Michigan.
SHOULD THERE BE FEDERAL FUNDING FOR ABORTIONS?
Social Work on Psychotherapy In social work, “psychotherapies are being used to address social problems such as the social isolation of the aged, youth, the neglect and abuse of children, homelessness, drug addiction, and AIDS” (Specht, 1990, p.354).
This article examines how “psychotherapy is not useful in dealing with these types of problems” (Specht, 1990, p. 354). The data in this article discussed how our mission in social work practices, “must be to build a meaning, a purpose, and a sense of obligation for the community, not one by one” (Specht, 1990, p. 355). By creating a community that we establish we have a basis for commitment, obligation, and social support” (Specht, 1990, p.355). Specht (1990) suggests, that “psychotherapy will not enable us to build communities, and the farther down the psychotherapeutic path we go, the less effective we will be in achieving our true mission” (Specht, 1990, p.355).
Article Critique The Specht (1990) article looks at social work in a negative way. Social work practice has to deal with people on the Macro level. Social workers look at the whole picture when working with the elderly, homeless, abused and neglected children, mentally ill, poor, people who are addicted to drugs and alcohol, and AIDS. By working in the field with many different clients, you have to help one client at a time. When you help clients on an individual basis, you as the worker build a rapport with the client and you get a better sense of their
needs.
SHOULD THERE BE FEDERAL FUNDING FOR ABORTIONS?
Social Work Practice with Vulnerable Populations Social workers in today’s society deal with vulnerable populations that live oppressed lives. These people feel powerless and feel like there is nobody who can help them with their problems. When “community, and family supports are weak or unavailable and when internal resources are unavailable, these populations are vulnerable to physical, cognitive, emotional, social deterioration” (Gitterman, 1991, p.1) As social workers provide social services to the disadvantaged and to vulnerable populations, the task is more difficult to fulfill. The “problems that clients face steady increase, but the amount of resources have decreased” (Gitterman, 1991), p.1).
Book Critique In the Gitterman (1991) book, he did a fabulous job with explaining how social workers try to advocate for clients, but the lack of resources makes it harder for them to be successful. Vulnerable populations can be a challenge to work with, but once you establish the rapport with these clients, you get a better idea of what types of help they need. These group of people are more willing to trust you and you have a better chance of empowering them to be successful.
SHOULD THERE BE FEDERAL FUNDING FOR ABORTIONS?
Conclusion
With all of the research that has been done on abortion, I feel that Medicaid should only cover the costs of abortion if a woman has been raped, she has been a victim of incest, or her life is in danger. I feel that if Medicaid provided coverage for abortions, women would take advantage of the system. Abortions are very expensive. Unfortunately, I got pregnant when I was getting ready to graduate from high school. At the time, I was not married and I was not ready to have a family. I was not working at the time and didn’t have any money for an abortion. I told my mom about the situation and she went to the abortion clinic with me and gave me the money to have the procedure. done. The procedure was $300.00. I was lucky to have my parents as my support system. There are a lot of women in today’s society, who don’t have family or friends to help them in any situation. Women need to be empowered to make better decisions about their health and well-being. Planned Parenthood is an excellent resource for women to receive annual exams, birth control, pregnancy options information, information on abnormal pap tests, sexually transmitted disease testing and treatment, pregnancy testing, emergency contraception, and HIV testing and education.
SHOULD THERE BE FEDERAL FUNDING FOR ABORTIONS?
References
Dennis, A. and Blanchard, K. (2013), Abortion Providers ' Experiences with Medicaid Abortion Coverage Policies: A Qualitative Multistate Study. Health Services Research, 48: 236–252. doi: http://dx.doi.org/10.1111 /j.1475-6773.2012.01443.x
Gitterman, A., (1991). Handbook of Social Work Practice with Vulnerable Populations. New York, New York: Columbia University Press.
Gretchen, E. Ely & Catherine N. Dulmus (2010): Abortion Policy and Vulnerable Women in the United States: A Call for Social Work Policy Practice, Journal of Human Behavior in the Social Environment, 20:5, 658-671. doi: http://dx.doi.org/10.1080/10911351003749177
Hasenfeld, Y. (2000). Organizational Forms as Moral Practices: The Case of Welfare Departments. Social Service Review, 74(3), 329-351.
Levine, P. B., Trainor, A. B., & Zimmerman, D. J. (1996). The Effect of Medicaid Abortion Funding Restrictions on Abortions, Pregnancies and Births. Journal of Heath Economics, 15(5), 555-578.
Medoff, M. H. (2008). The Response of Abortion Demand to Changes in Abortion Costs. Social Indicators Research, 87(2), 329-346. doi: http://dx.doi.org/10.1111 /j.1475-6773.2012.01443.x
Medoff, M. (2010). The Impact of State Abortion Policies on Teen Pregnancy Rates. Social Indicators Research, 97(2), 177-189. doi:http://dx.doi.org/10.1007/s11205-009-9495-9
Rodman, Sarvis, Bonar., (1987). The Abortion Question. New York, New York: Columbia University Press.
Specht, H. (1990). Social Work and the Popular Psychotherapies. Social Service Review, . 64(3), 345-357.
Taylor, S. A. (1998). Abortion: A History of Abortion Laws in Michigan: Michigan Legislative Service Bureau. Legislative Research Division. Research Report Vol. 18, No. 2.