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."


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."