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So now Republican state legislators want to deny women insurance coverage for abortions, even those willing to pay for a special rider with their own dollars.
You would think abortion is illegal, or that everyone in the country holds the same religious view on when life begins. It isn't. We don't.
But for those who oppose abortion rights, there is always another way to make it as difficult and as expensive as possible to exercise them.
It isn't enough that women in the armed forces serving their country in time of war can't use their government insurance to end a pregnancy unless it endangers her life. Who cares if it's the result of rape.
Nor is it sufficient that poor women in most states, women who struggle to pay rent and feed families, must either have the baby or somehow scrape together $413 for an abortion, which was the average 2006 cost in the 10th week. Who needs to eat?
That the health-care overhaul passed by Congress last month continues the ban on federal funding for abortions -- expanded it, by some accounts -- isn't enough, either.
Using another provision in the new legislation, Republican lawmakers in six states are trying to prevent all private insurance plans in yet-to-be-formed exchanges from offering any kind of abortion coverage, the Wall Street Journal reported this week. Nor could women pay extra, with their own money, to buy abortion coverage.
If the pro-children movement were as effective as the anti- abortion rights movement, child poverty would vanish from the country. Each youngster would have access to a solid education and decent medical care. None would suffer from abuse or neglect.
(Hold the e-mail. I'm not saying children would be better off never-born than poor. It's just that I wish the energy spent on limiting abortion rights were put to good use.)
As it is, at least 13.3 million Americans younger than 18 were living below the poverty line in 2007, which was $17,170 for a family of three.
The anti-abortion rights crowd is so good at getting their way that it's hard to believe the U.S. Supreme Court ruled more than 35 years ago that states can't ban abortions. Or that a 1992 decision weakening Roe v. Wade nonetheless forbade states from putting an "undue burden" on women seeking abortions.
True, the high court has also upheld bans on the use of federal funds for abortion. And the court, led by Chief Justice John Roberts, ignored precedent in 2005 to say for the first time that an abortion restriction can be constitutional even when it doesn't make an exception for the health of the woman.
My point is that anti-abortion forces have become so powerful that by the time the Supreme Court decides to reconsider Roe v. Wade, there won't be many abortion rights to strike down or protect.
It turns out that four states already forbid most private insurance plans from offering abortion coverage except when the woman's life is in danger, according to the Guttmacher Institute, which researches sexual and reproductive health matters. A fifth allows coverage in cases of rape and incest, too.
In those states, customers can pay extra for insurance riders. (Whether anyone actually buys the riders is a very good question.)
It's too early to know the result of state efforts to totally bar abortion coverage in plans that would be listed within the exchanges. The law Congress passed requires states to set up the exchanges in 2014 for anyone not on Medicaid and for small businesses.
You will spend your own money to buy the insurance listed on the exchange. For lower income people, the government will subsidize premiums on a sliding scale.
Regardless of who pays for what coverage, access to abortion is already shrinking. States keep enacting more and more barriers. Waiting periods. Mandated counseling. Parental involvement. Additional requirements for physicians and hospitals.
"Their real plan is to ban abortion," says Elizabeth Nash, who oversees state actions for the Guttmacher Institute, which supports abortion rights.
Until they can win an outright ban, the anti-abortion rights people keep hammering away at access.
They know that a right isn't much good if people can't actually use it.