There are two roles anti-choicers like to play for which they are ill-equipped. First, they like to play doctor. And second, they like to play God. In doing so, they spread outright lies about both abortion and contraception to mislead and whip the public into a frenzy about sex, pregnancy, and childbirth. And then, believing themselves to be the righteous ones, they seek to capitalize on their self-created panics to make public health and medical policy for the country based solely on emotion, facts be damned. Their end goal, as they make clear, is to outlaw abortion and contraception no matter the costs to public health, women’s lives, or society writ large.
The trial of Kermit Gosnell provides anti-choicers and their allies with a perfect platform for their efforts. In Gosnell, they have an unethical, unscrupulous criminal acting as a doctor. He preyed on women too poor to seek early, safe abortion care, ran a filthy “clinic,” and conducted illegal abortions during which, it is alleged, some infants were born alive and killed. In their quest to make safe, legal abortion care as inaccessible as possible, anti-choicers are now seeking to sway public policy by conflating safe abortion care with Gosnell’s atrocities, to tar all legitimate providers of safe abortion care as Gosnell clones, and to use a criminal case as a justification to drive legitimate providers out of business.
One recent example of this effort comes courtesy of Washington Post columnist Jennifer Rubin, who, in a column Wednesday, suggested several ways to further diminish access to safe, legal abortion care in the United States through what she calls a “Gosnell amendment.” If you read the piece, it is clear she has no idea what she is talking about.
Rubin, for example, calls for changes in Medicaid but appears not to understand how Medicaid works in the first place. She also calls for changes in federal funding of abortions, but appears not to understand that current law already severely restricts public funding of abortion.
First, all Medicaid and other federal support for abortion services should come with caveats—health standards (of the type Pennsylvania refused to issue and enforce) and appropriate training for all personnel. Second, federal taxpayer dollars should not go for late-term abortions.
Let’s start out by making clear that this is the kind of grasping for irrelevant straws I described above (using the existence of a criminal to tar and feather an entire field of professionals who have no relationship to the criminal activity). For one thing, as confirmed in a phone call today to the Pennsylvania Department of Public Welfare, and notwithstanding the fact that what he did was illegal in the first place so the case illustrates nothing about safe abortion care, Gosnell was not receiving Medicaid payments for women seeking abortion. In fact, in 2010, there were only seven abortions in the entire state of Pennsylvania paid for by state tax funds, and no federally funded abortions anywhere in the state that year. As in zero. Zip.
But no mind: Rubin claims that Gosnell proves there are problems with federal Medicaid funding of abortion care, because eliminating Medicaid funding of abortions for any low-income woman under any circumstance is high on the anti-choice agenda and Gosnell gives them a platform for their arguments.
As for regulations and “health standards,” both the Centers for Medicaid and Medicare Services and state Medicaid agencies already work together both to certify and regulate Medicaid providers of all kinds, and both medical societies and advisory boards at the state and federal level set standards for care. Does this mean there is never any fraud? Of course not: Republican Rick Scott, the current governor of Florida, was implicated in one of the biggest Medicare frauds in the country in the late ’90s, showing that laws on the books are in fact broken until evidence is accumulated to bring a case. It was not lack of law or regulation, but rather lack of enforcement that allowed Gosnell to carry on for so long. Changes to Medicaid would therefore not have prevented and will not prevent past, current, or future quacks or criminals from operating in such a capacity until they are caught, just as homicide laws will never prevent all homicides and laws against arson won’t eliminate arsonists. Laws and regulations are meant both to define and to hopefully reduce criminal activity but will never eliminate it.
Rubin’s suggestion that federal taxpayer dollars should not go for abortions also is a head-scratcher, since the Hyde Amendment already forbids the use of federal funds for abortions except in cases of life endangerment, rape, or incest. This law has guided public funding for abortions for low-income women under joint federal and state programs since 1977. At a minimum, states must cover those abortions that meet the federal exceptions. States also are free to expand coverage of Medicaid funding of abortion for other reasons, using their own funds. Pennsylvania does not offer expanded Medicaid coverage for abortion.
Moreover, the system in Pennsylvania (as in many states) is such that even in cases of rape and incest it is virtually impossible to get reimbursed for a Medicaid-eligible abortion. As Claire Keyes, former director of a clinic in Pennsylvania, told RH Reality Check via email: