Abortion coverage alters for servicewomen
By Adam Sonfield
Senior Public Policy Associate
Guttmacher Institute
Washington, DC
In one of its final acts, the lame-duck 112th Congress did something unprecedented over its two-year term: It expanded access to publicly financed abortion, ever so slightly. The 2013 National Defense Authorization Act, which was approved by Congress in late December 2012 and signed by President Obama on Jan. 2, 2013, includes a provision authored by Sen. Jeanne Shaheen (D-NH) that reverses a decades-long ban on federally supported insurance coverage for abortion in cases of rape and incest for military servicewomen and female military dependents. Since 1981, federal law had limited military abortion coverage to cases in which the woman's life is endangered.
The prohibition on abortion coverage in cases of rape was particularly harmful for the more than 200,000 women serving on active duty in the military. Defense Department statistics for a single year, 2010, identify more than 3,000 reported sexual assaults, including roughly 875 rapes; yet the extent of the problem is considerably larger, with an estimated 86% of assaults going unreported.1 In an interview with Mother Jones in June 2012, Sen. Shaheen noted, "Most of the women affected here are enlisted women who are making about $18,000 a year. They're young, they don't have access to a lot of resources. Many of them are overseas."2
The Shaheen Amendment garnered support from dozens of retired military leaders, including Colin Powell, the former secretary of state and chairman of the Joint Chiefs of Staff, and it had significant bipartisan support in Congress. By banning coverage of abortion in cases of rape and incest, the restrictions on the military insurance program, known as TRICARE, were more severe than restrictions on most other federally supported insurance programs, including the most famous of the policies: the Hyde Amendment, which bars federal payments for abortion under Medicaid, except in cases of life endangerment, rape, or incest. Advocates of changing the military policy could point to the fact that servicewomen were receiving worse coverage than the civilians they risk their life to protect.
Restrictions to change?
Several other federal abortion restrictions fit this same mold — more restrictive than the Hyde Amendment — and are being looked to by abortion rights advocates as the best short-run opportunities for further progress at the federal level. Federal law, for example, restricts abortion coverage even in cases of life endangerment, rape, or incest for members of the Peace Corps, and federal policy bars U.S. funding of abortion even in those same extreme cases in the nation's international aid programs.3 Another provision bars the District of Columbia from using its own locally raised revenue to pay for abortion coverage for its low-income residents. That ban was briefly eliminated for FY 2010 — proponents of lifting the ban focused on its infringement on the District's right to home rule — but it was reinstated again the next year at the demand of House Republicans as part of a broader budget deal. Finally, the Shaheen Amendment leaves in place a separate statutory restriction affecting military servicewomen that prohibits abortions from being provided at military medical facilities, even if a servicewoman were to pay for the procedure entirely with her own funds.4 That restriction is particularly harmful for women stationed overseas, many of whom are in countries where abortion is illegal and unsafe.
Neither the Shaheen Amendment nor any of these other short-run opportunities challenge the essence of the Hyde Amendment or its progenies, including abortion coverage restrictions affecting federal employees and their dependents, Native American women, and women in federal prisons and detention centers. Those restrictions have set a federal standard that coverage for abortion, unlike coverage for other types of healthcare, is at best permissible only in the most extreme circumstances.
Abortion rights advocates were cautiously hopeful when President Obama first took office in 2009 that he would lend his weight to challenging that standard. Yet, he failed to take any steps in that direction during his first term in office. Moreover, he agreed to extend the federal restrictions on abortion coverage to millions of additional women under the Patient Protection and Affordable Care Act as a condition of support for the health reform legislation from antiabortion Democrats.5
References
- Department of Defense. Department of Defense Annual Report on Sexual Assault in the Military: Fiscal Year 2010. Washington, DC; March 2011. Accessed at: http://bit.ly/fB8y9V.
- Sheppard K. House GOP blocking abortion access for raped soldiers. Mother Jones, Jun. 13, 2012. Accessed at http://bit.ly/L6qtqz .
- Boonstra H. The heart of the matter: public funding of abortion for poor women in the United States. Guttmacher Policy Review 2007; 10(1):12-16.
- Boonstra H. Off base: The U.S. military's ban on privately funded abortions. Guttmacher Policy Review 2010; 13(3):2-7.
- Cohen S. Insurance coverage of abortion: the battle to date and the battle to come. Guttmacher Policy Review 2010; 13(4):2-6.
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