The Ohio legislature is currently considering a measure that would institute a sweeping ban on insurance coverage for abortion in state residents’ public and private health plans. Restricting women’s ability to use their insurance plans to pay for abortion is becoming an increasingly popular anti-choice strategy — and Ohio’s proposed legislation may actually go even further. The measure would also make it harder for low-income women to afford the most effective form of birth control.
House Bill 351, which was the subject of a committee hearing on Tuesday, seeks to prohibit insurance plans from covering “drugs or devices used to prevent the implantation of a fertilized ovum.” That definition effectively bans several types of contraception, like the birth control pill and the IUD.
Residents with public insurance — which includes state government employees as well as low-income individuals who rely on Medicaid — are already prevented from using their coverage for most abortions. But since HB 351 stipulates they also can’t use it for any drugs that inhibit implantation, the legislation could end up functioning as a birth control ban for public insurance plans.
Rep. John Becker (R), who sponsored the bill, said during Tuesday’s hearing that birth control pills should not be banned under HB 351. But he still wants IUDs, which are long-acting forms of birth control that are inserted in the uterus, to fall under the ban because he considers IUDs to be a form of abortion. “This is just a personal view. I’m not a medical doctor,” he said.
Nonetheless, if HB 351 is approved, Becker’s personal view could end up having serious medical consequences for women across the state — including the economically disadvantaged women on Medicaid, who are already most at risk for unintended pregnancy.
The unintended pregnancy rate for women living below the poverty level is more than five times as high than the rate for the women in the highest income level, largely because they struggle to access affordable birth control. Since long-lasting forms of birth control like the IUD remain effective for years without the need to take a daily pill or a monthly shot, public health experts recommend them for women who struggle with avoiding pregnancy. But IUDs are expensive, and can cost as much as $1,000 upfront. A large 2012 study focusing on low-income women in St. Louis found that when cost barriers to IUDs are removed, more women choose them and fewer women end up needing abortions.
Social conservatives’ crusade against abortion, which often hinges on redefining some forms of contraception as “abortion-inducing drugs,” has ensured that IUDs are continually caught in the crossfires. This is the same type of birth control that Hobby Lobby, the crafts company that sued the Obama administration over the health law’s contraceptive coverage requirement, doesn’t want to offer to its employees.
Of course, aside from the implications for birth control access, HB 351 would also impose a significant financial burden on the women who need abortion services. The bill does not include any exceptions for women who became pregnant from rape or who are faced with a pregnancy that threatens their life, which means even the Ohioans who find themselves in those desperate circumstances would be forced to pay for the entire cost of the procedure out of pocket. An in-clinic abortion during the first trimester can cost anywhere from $300 and $950. Later procedures, which are typically necessary when women discover serious health issues with their pregnancies or their fetuses, can be thousands of dollars.
“Every day in this state, women face the complex decision of whether to choose adoption, end a pregnancy, or raise a child,” Stephanie Kight, the president of Planned Parenthood Advocates of Ohio, said in a statement. “Politicians have no place in this decision-making process, and that includes using financial restrictions to force a woman’s decision.”