Abortion

Obamacare to Blame for U.S. Abortion Clinic Shutdowns?

Vox writer suggests Obamacare is "one root cause" of U.S. abortion clinics "shuttering at an unprecedented rate."

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Kieran Bennett/Flickr

Vox writer Sarah Kliff recently looked at "how the pro-life movement is winning" the abortion battle, passing a record 205 abortion restrictions around the U.S. between 2011 and 2013, and many more since. In cities such as Cincinnati, Ohio, and states such as Louisiana and Mississippi, these politically motivated rules have forced all but one or a few abortion clinics to close. Elizabeth Nash of the Guttmacher Institute told Kliff that "accessing abortions is much more difficult in 2014 than in 2009." 

"These changes are a clear result of pro-life mobilization in the Obama era," writes Kliff, blaming both decreased urgency on the pro-choice side and increased advocacy among anti-abortion advocates since President Obama took office. It's plausible enough. But then Kliff makes this statement: "Abortion clinics across the country are shuttering at an unprecedented rate—and one root cause is Obamacare."

Interesting. How does she figure? The Affordable Care Act "allows plans sold on the marketplaces to pay for abortions, a provision anti-abortion legislators lobbied hard against but ultimately lost," and this has mobilized the pro-life movement, Kliff explains. "State legislators… quickly took up the cause, and in the past five years, 25 states have moved to ban or limit abortion coverage in the Obamacare markets."

This is true, and it contributes to the total number of abortion restrictions passed, sure. But it's relatively irrelevant to abortion-clinic closures. The only way the two could be related is if a "root cause" of clinics closing is fewer patients seeking abortions due to a newfound lack of insurance coverage. Yet there's no evidence that clinics are closing due to a lack of abortion demand. Rather, many flailing or now-defunct clinics have been unable to comply with the hoop-jumping state legislatures have decided to require.

In Ohio, for instance, rules passed in 2013 require abortion clinics to have transfer agreements with a local, private hospital. But private hospitals—which, in Cincinnati, are largely run by Catholic health care systems—don't have to grant admitting privileges to any of them. Abortion clinics literally cannot comply with the law and are hence forced to close, not becuase of any medical malpractice or potential for danger but because they can't meet arbitrarily chosen and impossibly stacked rules. 

The USA Today editorial board (not known for being particularly liberal) yesterday called out state legislators for saddling women "with so many onerous strictures" that legal abortion has become effectively meaningless in some places. "Women in some parts of Texas must travel hundreds of miles round-trip to exercise their rights, thanks to the law requiring that all clinics meet hospital-like standards for surgery centers and that all providers affiliate with hospitals," the editorial board notes.

Both requirements might sound reasonable, but a federal judge found the building standards so tangential "to patient safety … as to be nearly arbitrary." And two major medical groups say obtaining hospital privileges adds "no medical benefit" for patients, who could be harmed by having less access to safe abortions.

In an opposing editorial, Charmaine Yoest, president of Americans United for Life, accused those who qustion such restrictions as "politicalizing and radicalizing women's health care." 

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  1. I blame Bush

    1. I blame Darth Cheney.

      1. I blame the Mourning Lynx

        1. I’m pretty certain Tricky Dick Nixon had a hand in this.

  2. Increasing the frequency that people are forced to pay for a service they find morally repugnant results in them putting more effort into under-cutting the requirement to pay for that service. Who’d have thunk it?

    1. yeah but that consequence wasn’t intended, and we as a society seem to judge morality by intent.

      1. The road to Hell…something, something…good intentions…yada, yada…..

  3. Brilliant woman but she *gots to run the techno on those letters arrangements.

    *ebonic sliver

  4. There are similar restrictions on midwifery, but that’s different, eh ENB? Who needs medical/surgical safety when you have rights to consider.

    I’m no champion for government restrictions but, were I a woman getting an abortion, I’d rather drive 100 miles to get the procedure than bleed out while traveling that 100 miles by ambulance after a problematic abortion procedure. While informed consent is better than government regulation, it is not necessarily true–as you suggest–that abortion parlors are solely targeted.

    A woman certainly has a right to endanger her life, and that of her child, either aborting a baby or delivering one, but don’t claim that it’s all about abortion politics.

    1. “than bleed out while traveling that 100 miles by ambulance after a problematic abortion procedure”

      Lol

      1. You really are naive, aren’t you. If a woman starts bleeding–for any reason–during an abortion, do you think they just put a band-aid inside her uterus? Hemorrhaging can occur during a surgical procedure, or even with an abortion pill.

        1. The point is abortions are comparatively very safe procedures, the cases of women ‘bleeding out’ after one are really, really small, lower than comparable procedures that don’t get the same kind of regulatory response.

          http://www.ncbi.nlm.nih.gov/pubmed/22270271

          1. What comparable procedures that don’t get the same kind of regulatory response? You link doesn’t say.

            1. How about colonoscopy for one.

              1. Colonoscopy? You mean that procedure that’s usually done in a hospital?

                Are there ‘colonoscopic clinics’ that face less regulation than abortion clinics?

                All the ones I looked up seem to have stuff like admitting privileges.

                1. Aaaaannndd Bo is shot down on this front.

              2. Colonoscopy is diagnostic.

                Surgical abortions of the sort that the Texas law regulated, are, well, surgical.

                The difference in risk to the patient is profound.

                My recollection of the Texas regs is that they swept a little too broadly, but that abortions were a surgical procedure that was regulated more lightly than many others.

                And, once again, we see that the King Right in the US isn’t any of the ones mentioned in the BoR: its abortion. Gun stores labor under all sorts of regulatory restrictions, but get no slack because they are providing the means to exercise a Constitutional right. Yet, abortion providers do, thus, in the US, the right to an abortion is more valued than the right to self-defense.

                To me, that’s nuts.

                1. Azathoth,

                  Yes, in the big city, colonoscopy is done in gastroenterologists’ office/clinics. Yes, all clinics suffer from these petty politics.

                  Colonoscopy is surgery, with major risks, as common as the risks of elective abortions. Ignorance of the medical landscape results in incorrect assumptions being made here. Any way you look at it, it boils down to petty politics being used to restrict the competition’s practice of medicine.

          2. Do you understand why babies and mothers are so much more likely to survive birth today than even 75 years ago? Because of medical, technological and procedural advances not so common in abortion and midwifery clinics.

            Nonetheless, you are correct that the chances of death are very small. But those chances are greatly increased when the hospital is half an hour or more away–no matter the emergency.

            As I said above, informed consent is better than government regulation. But the danger is still there. So, you can put your life in greater danger so that you can exercise your rights if you like. I’m going to a real surgical center any time I have surgery.

            1. The chances of *complication* in the first place are very small.

              1. Well, fuck it then, you insufferable, ignorant bore. Let’s just go back to coathangers in the truckstop bathroom, if safety is unimportant. Not all clinics are alike. Can you get that through your skull?

                As I’ve said twice already: informed consent is best. Still, safety is not a matter of chance. It requires knowledge, research, planning and practice. But you can’t get that because you’ve not likely done anything more complicated than read books and take tests.

              2. And making them even smaller is ideal. Do you not get that? Eliminating the possibility of complication is an ongoing goal.

                Remember–the word ‘complication’ is hiding ‘something terrible has just happened to me or one of my loved ones’.

                1. Complications are things that are often uncontrollable. It is the reason that these Xarelto lawyers seem to be around every corner, here on the Internet. If you don’t think you are at risk of a complication, then maybe you should get a little more educated. All medications (look up aspirin) and procedures carry risks, including the risk of DEATH! It is, in no way, hiding a damned thing!

          3. It may seem petty to you, (me too!) but this type of logic has been used to restrict the competition (other doctors) from being granted privileges at some regional hospitals. The same reasons used being distance to the hospitals. These doctors’ houses, in these instances, being no further away than big city hospitals were, from the corresponding domiciles of their physicians. It is politics as usual in the practice of medicine. You think the patient matters…THINK AGAIN! It is all about how much money the competition is making!

    2. Does no one find it problematic that places 100 miles from a hospital actually exist? It comes up all the time in the abortion context, but no one ever cites the lack of hospitals as a problem in and of itself.

      1. I used to live in a place 40 miles away from the nearest gas station. Texas is a big place, and some of it is very sparsely populated.

        1. Sounds like a personal problem to me. I hope you moved somewhere with more neighbors. By the way, where were you in Texas?

          1. Wasn’t really a problem. I was a kid at the time and a heavy introvert. Living out there meant I got to wander all over the wilderness with no supervision. Wouldn’t want to go back now because out internet was crap, but it was good at the time.

            I lived a good ways off the highway halfway between Houston and DFW.

      2. Does no one find it problematic that places 100 miles from a hospital actually exist?

        In West Texas, sure, there might be a few. But, and take it from somebody who was in the hospital biz there, I don’t actually believe that there are any physician offices or abortion clinics more than 100 miles from a hospital. They tend to all be in the same little town, the county seat.

      3. Does no one find it problematic that places 100 miles from a hospital actually exist?

        I take it you’ve never driven through Wyoming, or Montana, or Alaska, or…well…lots of places.

  5. There’s a much simpler explanation, so of course a Vox writer would skip it: Obama is a very polarizing figure, those who don’t like him *really* don’t like him and they turn out comparatively well in mid-term elections, and very importantly they did so in the 2010 elections which decided district line drawing. As a result far more state legislatures than before are controlled by groups that really don’t like Obama, and such groups have significant overlap with pro-life forces, and laws get passed.

    1. You know who else was a very polarizing figure?

        1. Fassbender or Gandalf?

          1. Do you mean which one would win in a fight or which one would I do?

            1. The answer’s not the same?

              1. Not for me. Mike I want on my side in a fight, Ian seems like a tender lover.

                1. +1 White Rider

          2. David Hemblen

        2. Close. The correct answer was Edwin Land.

      1. Bo Cara, Esq.?

        1. I said polarizing, not idiotic.

  6. The USA Today editorial board (not known for being particularly liberal)

    While not quite as extremist as the NYTs unsigned USA Today “Our View” editorials are “particularly liberal”.

  7. The Affordable Care Act “allows plans sold on the marketplaces to pay for abortions, a provision anti-abortion legislators lobbied hard against but ultimately lost…”

    Since we know that failing to pay for someone’s medical procedure is the same as restricting access to it, shouldn’t it follow that the reverse equates to expanding access? Case closed.

    1. You are correct – and since Obama himself said if you like your insurance you can keep your insurance what’s all this nonsense about insurance no longer covering abortions like it used to? As for me, I think he who pays the piper calls the tune – if you want government to pay for everybody’s healthcare and don’t think I have a right to bitch when the government tells me I can’t smoke or drink a gallon of Pepsi or ride my motorcycle without a helmet because they’re the ones paying my medical bills then I don’t want to hear you bitching when they decide you can’t have an abortion. That’s a tiny little future taxpayer and potential Democratic voter you’re snuffing there, you heartless bitch. Who the hell are we supposed to tax to pay for your nursing home if you keep killing off the little serfs?

      1. Nicely done, Jerryskids. You were really on a roll during that rant. Keep up the good work!

  8. “a federal judge found the building standards so tangential “to patient safety … as to be nearly arbitrary.””

    If we were talking about any issue other than abortion the left would have a shit fit at a judges insinuation that medical facility standards were too strict.

    1. LOCHNERISM!

    2. Exactly. Note how this is only a problem for abortion, the King Right in the US.

      We have a rule here in AZ that you cannot walk through unlicensed space to get to licensed space. Talk about “tangential to patient safety” and “arbitrary”, yet somehow its not a big frickin’ Constitutional disaster. Funny, that.

    3. If we were talking about any issue other than abortion the left would have a shit fit at a judges insinuation that medical facility standards were too strict.

      And the right would have a fit at using regulatory law in such a targeted way to make it impossible for a business to operate–ah, who am I kidding, the right doesn’t give a shit about that in any case.

      1. Yeah, look at how the Repubs and their fellow travellers blew up when all these local restrictions were put on gun stores. . . .

  9. http://www.dailymail.co.uk/new…..lture.html

    Visual enjoyment of the nude human form has existed for centuries, you simple-minded prudish cunt from bleak village, which is the fuck why the goddamn ‘lewd’ pop and porn star exist at all. They serve a market desire that is as relevant as that created by millions salivating over pulled pork in sticky icky sauce on a hot bun.

    The single reason there exists something of a ‘culture’ as your distressed cerebellum hysterically foams on about is simply due to slightly less tyrannical intervention from violent moralists armed with social justice arrows and bible bullets.

    Suck my galactic phallic of liquid astral magic, you raving anti-sex lunatic.

    1. You leave Chrissie Hynde alone!

      1. Hynde, the singer, is svelte and delightful on the ears and mind. Hynde the fucking social justice cunt is a skull full of chainsaws. So, as always it seems, in this existence things rattle about with ominous and spectacular tones depending on the obtuse orientation, my fine Juggling friend.

        1. You are both Ohioans! You have to stick together. You must stick together. If not you, then who? She is counting on you. We are all counting on you.

        2. skull full of chainsaws

          Sweet. You da man, AC.

    2. Never ceases to amaze me, the functionality of this model.

  10. “accessing abortions is much more difficult in 2014 than in 2009.”

    But apparently, the demand for abortions (like the number of people employed) is back to levels last seen in 1973…so fewer clinics does not necessarily mean more difficulty…it may just mean less demand…the ‘rate’ stats at the link below (which go to 2011) show that the decrease began before the restrictions. So, maybe economics has more to do than politics?

    US Abortion rate

  11. I can’t help but think that if the pro-choice movement would actually come down like a ton of bricks on the very few clinics that are run like unsanitary chop shops instead of defending them or trying to obfuscate when they come to light, the pro-life movement wouldn’t have such as easy task of making them look repulsive.

    1. Great point. ENB makes it sound as if only the “life” side is political. Both sides are political and each side could do more to help women and unborn children if they would focus on them instead of focusing on beating each other in the courts and the legislatures.

    2. Pretty much. I’m to young to remember the abortion bombings, but Gosnell wasn’t to long ago.

    3. And, the pro-choicers loved to antagonize religious types who were anti-abortion. Obama was the impetus for them to get really organized and fight back.

    4. They can’t even bring themselves to give lip-service to condemning the recent baby-part-selling videos. At least gun-nuts have the decency to condemn mass-shooters while refusing to compromise on their issue.

      Actually now that I write it I think abortion is the liberal equivalent of guns. They view any attempt at restriction, regardless of how “reasonable” it might be (facility requirements = universal background checks?) as an unconscionable restriction which will simply lead to an all-out ban.

      1. Actually now that I write it I think abortion is the liberal equivalent of guns.

        Not exactly. One key difference is that the mere possession and carrying of a gun does not cause harm to anyone or anything, even a fetus.

        The analogy is better if the gun ban lobby were also trying to ban the use of guns in self-defense. They would like to, but since 90% of the American public supports self-defense with deadly force, the gun ban lobby has to try to ban guns.

    5. “I can’t help but think that if the pro-choice movement would actually come down like a ton of bricks on the very few clinics that are run like unsanitary chop shops instead of defending them or trying to obfuscate when they come to light, the pro-life movement wouldn’t have such as easy task of making them look repulsive.”

      Acknowledging the problems with the “chop shops” would lead to increased regulation of the clinics, so you can see why the choicers want to minimize the problem.

  12. Obamacare to blame for late AM Links?

  13. Ahem, writers. It’s 9:03 AM. Nine-Oh-Three. It’s okay if you haven’t found a Trump link for the AM Lynx yet, we’ll get enough Trump news later today.

  14. Lynx are late. I blame ENB.

    1. She needs a higher comment count on her Abortion post…d’oh

    2. Yes, now is the time to blithely start flinging blame around.

      Good Lord, 9:05!

    3. AM Links have been… aborted.

      YEEEAAAHHHHHHH!

  15. I blame ::spins the wheel of Blame:: FoE. He’s running behind this morning, and his blatant conspiracy with Reason writers means they won’t post until he’s ready.

    1. Oh, are Links not posted yet?

    2. Maybe Swiss is still warming up his eye muscles.

  16. Mourning lynx aborted; women, minorities hardest hit

  17. While we wait for links, take a gander at this man, who may be the King of all Hipster Douchebags. Arrested for attacking a car while driving the wrong way down the street during a Critical Mass ride. But his mommy says he didn’t do anything wrong! (he’s 39)

    1. Nobody should have a mustache like that unless they’re pitching for the Oakland A’s.

    2. On video? No.

  18. “Both requirements might sound reasonable, but a federal judge found the building standards so tangential “to patient safety … as to be nearly arbitrary.” And two major medical groups say obtaining hospital privileges adds “no medical benefit” for patients, who could be harmed by having less access to safe abortions.”

    Hmmm….it’s almost like subjecting medical decisions to the vote of a committee of a few hundred people that know nothing about medicine and have no incentive to make good decisions is a bad idea. Wonder why liberals don’t realize the same applies to just about every other area of government regulation.

  19. “”Women in some parts of Texas must travel hundreds of miles round-trip to exercise their rights, ”

    And I have to drive a very long way to exercise my right to see lions and tigers. It’s so unfair!

  20. Are the rules being put on abortion clinics more than what is required for other outpatient surgical clinics? If not, why are they not onerous or unreasonable for those other clinics? Does right to privacy not apply to other medical procedures?

    I love how pro abortion rights people successfullylobbied to have abort I’ll included in obamacare plans, but only pro life initiatives are politically motivated.

    1. Are the rules being put on abortion clinics more than what is required for other outpatient surgical clinics?

      They are, essentially, applying ASC rules to abortion clinics (defined as physician offices, ASCs, hospitals, etc. who do more than X abortions per year). Which, frankly, is a bit of a stretch, but one wonders by how much, since “non-medical” abortions are surgical procedures.

  21. Obamacare provides free birth control pills. shouldn’t there be fewer unwanted pregnancies?shouldn’t demand for abortions go down accordingly? shouldn’t clinics therefore close as a consequence?

  22. “Hospital like standards,” are another term for “how we can limit competition by other medical facilities.” Abortion aside, we will need to get rid of hospital like standards and the various boards of certification and standardization and accrediting before we can have less expensive healthcare. The healthcare industry will of course fight any an all attempts to do so as “attempts to make healthcare less safe,” and “rolling back the patient safety standards so important for the people.”

    In other words, we’re screwed and we’ll continue to have tightly regulated, outrageously expensive medical care.

  23. “In cities such as Cincinnati, Ohio, and states such as Louisiana and Mississippi, these politically motivated rules have forced all but one or a few abortion clinics to close”

    #BlackUnbornBabiesLivesMatter

    Just sayin’

  24. Yes, the conviction of Gosnell, and the sleazy practices of his fellow “clinic” operators, has nothing to do with it.

  25. The anti abortion/pro life cabal, like the anti gun rights/anti self defense cabal must be fought continuously, and at all levels. To do less is to ultimately lose the battle. By the way,”ultimately” might be a lot closer than some realize of would admit.

  26. Ms Brown,

    Abortion clinics are closing because medical abortions of gestation are much, much more profitable than surgical abortion of gestation.
    Medical abortions of gestation will soon be almost the only type allowed. Roe will soon be augmented instead of overturned. The 40 years since Roe has allowed science to allow EMTs to better detect life or the end of lives. Failing to breathe does not indicate death but failing to have a heartbeat does. A heartbeat now announces life! When the same test for life is done on a pregnant woman and life is detected, the right to privacy and to autonomy are no longer controlling. After the “potential human” develops a heartbeat. The Ninth Amendment Right to Privacy can no longer displace the evidence of life to the public and the duty ro protect this life (heartbeat) from a natural beginning to a natural end.

  27. “They told me if I voted for McCain in 2008 that we’d see abortion clinics shut down and they were right!”

    (Of course, they didn’t tell me that if I voted for Johnson in 2012, we’d see it, and that happened, too…)

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