As you deliberate upon the health care reform bill, we write to urge you to reject provisions that would effectively obstruct access to insurance coverage for abortion and interfere with the ability of women in the United States to make decisions about their own health care. The restrictive language contained in H.R. 3962, if signed into law, would have a direct impact on women's human rights to physical integrity, health, and nondiscrimination and could jeopardize public health. The precedent of government interference in profoundly personal health decisions would represent a dangerous departure from current US policy and human right standards. We urge you to make sure no similar restrictions are added to the Senate bill.
Human Rights Watch is one of the world's leading independent organizations dedicated to defending and advancing human rights. We carry out research on human rights violations in some 80 countries around the world and have investigated the consequences of legislation that restricts access to specific health interventions, such as abortion, across several continents and in numerous countries, including the United States.
In our experience and as evidenced by research from other organizations, legislation that seeks to limit access to health care and medical interventions generally both fails at its stated objective and has dire consequences for the human rights to physical integrity and health. As an example, abortion is as prevalent in countries where it is illegal as in countries where it is not. More importantly, restrictions on medical interventions that do not take into account respect for the full range of human rights tend to promote the use of unsafe and unregulated versions of those same procedures.
In fact, we have no doubt that by making abortion services exclusively available through personal funding, the abortion funding restrictions contained in the House bill would lead to two equally grave results:
- 1) Underground abortion services would flourish. Though abortion would not be criminalized by the language in HR 3962, unregulated abortion providers who are able to cut costs by compromising women's safety would likely find more demand. With statistics indicating that one out of three women in the US obtains an abortion in her lifetime, driving this demand underground will jeopardize the health of a staggering number of women.
- 2) Women with limited economic resources, who already face significant obstacles to safe abortion under current US law, would suffer the most. Abortion services have been subject to a federal funding ban since 1977 except in cases of life endangerment, rape, or incest. Furthermore, the majority of states do not provide funding for abortion services that fall outside these exceptions. A safe abortion often costs $500-$1,500. As a result, women with limited resources who have not been raped or whose lives are not endangered by their pregnancy may be forced to choose between carrying an unwanted pregnancy to term or taking desperate measures that could seriously jeopardize their health and lives. If the House language stands, the number of women affected by these obstacles would grow exponentially. That language would prohibit anyone receiving a federal subsidy for health insurance from using it in the newly created government exchange to purchase a comprehensive insurance plan including abortion coverage, except in cases of life endangerment, rape, or incest. This would significantly limit the accessibility of insurance coverage for abortion for many low and middle income women, and may indirectly undermine existing coverage for women on employer-based private plans, 87 percent of which cover abortion.
Further, the language of HR 3962 would establish a new precedent for government interference in this profoundly personal matter. Much more than an extension of the Hyde amendment and similar limitations on the use of federal funds for abortion, this move would mark a radical departure from existing law. HR 3962 would inhibit access to private insurance coverage for abortion, placing the government between patients and access to care. This is also squarely at odds with the recognition under international human rights law that decisions about abortion belong to a pregnant woman alone, to be made without unreasonable interference in the exercise of her full range of human rights.
As a party to the International Covenant on Civil and Political Rights, the United States has an obligation to protect, promote, and fulfill women's rights to physical integrity and equality under the law, without discrimination. As a signatory to the International Covenant on Economic, Social and Cultural Rights as well as to the Convention on the Elimination of All Forms of Discrimination Against Women, the United States further has an obligation not to act in a way that would defeat the object and purpose of those treaties. While the United States, as a signatory and not a party to these treaties, does not have an obligation to fully implement their provisions, it should not pass legislation that deliberately undermines the ability of women in the United States to pursue the fulfillment of their human rights and health goals through private insurance.
Marianne Mollmann Meghan Rhoad
Advocacy Director US Researcher
Women's Rights Division Women's Rights Division
Human Rights Watch Human Rights Watch