Stupak’s abortion stance threatens health of women and children

With the impasse between Rep. Bart Stupak and the Democratic leadership in the House getting deeper, it now appears more likely than ever that the northern Michigan legislator could end up preventing the passage of the health care reform bill in Congress in the name of stopping abortion — and, ironically, diminishing the availability of health care for pregnant woman in his district and their babies.

Stupak’s district currently has no facilities that perform abortions — the target of his opposition — but it does have several hospitals that have closed, or are soon to close, their obstetrics departments that provide vital pre- and post-natal care to pregnant women due to the high number of uninsured and Medicaid patients in the district, a problem that the bill he may prevent from passing would help solve.

Stupak, a former state trooper from Menominee, has represented northern Michigan in the U.S. House since 1993. His district, the largest in Michigan, covers a large chunk of rural northern lower Michigan and the entire Upper Peninsula.

Stupak says he is an advocate of health care reform.

“I have witnessed the struggles our families and employers face with our health care system,” he says on his website. “In Michigan, from 2000 to 2007, employer sponsored annual health insurance premiums rose from $6,817 to $12,151, an increase of 78.2 percent. Over the same period, the median earnings of Michigan’s workers increased from $25,910 to $27,096, an increase of only 4.6 percent.”

“Health care is not a privilege it is a basic right that should be afforded to all Americans.”

Despite this acknowledgment of the importance of health care reform, Stupak has essentially been holding health care reform hostage to his demand for language preventing all public funding for abortion. He says he speaks for 11 other House Democrats who are pro-life and that they will all refuse to vote for the current bill unless they get their way on abortion.

Since the House version of the bill — which contained an explicit ban on abortion funding via an amendment offered by Stupak — only passed by a three vote margin the first time, there is a very good chance this intransigence could kill the last chance for getting health care reform passed.

Indeed, Stupak himself said late last week that if the House leadership does not gain the votes of his group of anti-choice Democrats, they likely will not have the votes to pass the bill.

This stance is frustrating women’s rights advocates in northern Michigan, who point out that there already is no access to abortion for many women in Stupak’s district.

“Right now abortion is already restricted,” said Julie McKeiver, spokeswoman for Planned Parenthood of Western and Northern Michigan. “[Stupak’s amendment] would take away any reasonable expectation that they would get coverage of services.”

The regional Planned Parenthood organization has been forced by budget cuts to close clinics and reduce hours but maintains clinics that do not perform abortions in Petoskey and Marquette. Women who live in northern lower Michigan or the U.P. often must travel hundreds of miles to downstate abortion providers or cross into Wisconsin or Minnesota for services.

Unfortunately, abortion is not the only medical service not available to women in Stupak’s district without having to travel a long distance. It may be particularly ironic that if Stupak’s abortion concerns end up killing the health care reform bill, pregnant women in his district may lose access to the pre- and post-natal care that is crucial to the health of their babies. Increasing numbers of uninsured residents are putting a huge strain on hospitals and forcing them to close down their obstetrics departments.

According to the most recent data available from the Michigan Department of Community Health, 15.6 percent of Michigan’s non-elderly adults are uninsured, and northern lower Michigan has a higher than average rate of people who are uninsured.

Cheboygan Memorial Hospital closed its urgent care walk-in clinic last month and announced that it will discontinue its obstetric services this month because the high level of uninsured and Medicaid patients has bankrupted the unit. According to the hospital, in fiscal year 2009 CMH posted a $304,000 loss in the OB department.

In a statement the small hospital explained that its main service area includes not only Cheboygan County but also Presque Isle County, Montmorency County, the northern half of Emmet County, and the eastern half of Mackinac County, and that seasonal unemployment levels in some of these areas tops well over 25 percent.

With the closure of the CMH OB department, the closest facilities that can deliver babies and provide pre- and post-natal care would be Northern Michigan Regional Hospital in Petoskey, Otsego Memorial Hospital in Gaylord, Charlevoix Area Hospital, War Memorial Hospital in Sault Ste. Marie and Alpena Regional Medical Center. Many people within the CMH’s service area will face a drive of more than one hour under optimal conditions.

According to Cheboygan hospital officials obstetric services were eliminated in Clare a year ago and West Branch (also in Stupak’s district) is also contemplating ending OB services — all a result of the exploding number of patients that are either uninsured or on Medicaid, which pays far lower reimbursement rates for services than private insurance.

“As a matter of fact,“ hospital administration said in a statement, “when Cheboygan closes their OB unit at the end of this month, there will be 16 counties without obstetric services in the northern lower peninsula.”

Dr. Margaret Punch, Chair of the Michigan Section of the American Congress of Obstetricians and Gynecologists, told the Michigan Messenger that this diminishing availability of care for pregnant women in Stupak’s district is a serious danger to the health of mothers and babies.

“Having to travel longer distances for labor and delivery services is potentially very dangerous to both mother and baby, especially with unpredictable Michigan winter weather. At a time when we are hoping to increase access to affordable, quality health care, this is, indeed, very unfortunate.”

According to a report released Friday by Amnesty International, Michigan is already among the states with the highest levels of pregnancy-related mortality with 13.6 deaths for every 100,000 births and many more “near misses” in which birthing women experience complications that nearly kill them. The report, which does not include information about the obstetric unit closures this year, states that 43 percent of Michigan women live in medically under served areas.

Lawrence Barco, president of the MidMichigan Medical Center in Clare, which is just outside Stupak’s district and recently was forced to close its OB department, testified recently before a committee of the Michigan Senate about the problem of decreasing care for pregnant women in the state. He called the decision to close their OB department “heartrending because the childbearing women of our area tend to be poor and have transportation issues which increase the importance of having obstetrical services available as close as possible.”

“This population tends to be high risk and benefits more than most by having prenatal care, labor and delivery service and postnatal and pediatric services within easy travel distances,” he continued. “Minutes count when you’re delivering babies, and the lives and health of both mother and child are placed at risk when these services are not conveniently located.”

How would the health care reform bill help with those problems? By increasing the number of people with private health insurance, which pays higher reimbursement rates than Medicaid and dramatically reduces the number of people who are unable to pay for medical care at all.

According to the federal government, the health care reform bill would give 1.3 million uninsured Michigan residents — roughly 13 percent of the population — access to affordable health insurance.

That site also explains why the health care reform bill would help medical providers stay solvent and continue to offer crucial medical services. “Right now, providers in Michigan lose $2 billion in uncompensated care each year, which states subsidize at least in part. Instead, under reform, uncompensated care would begin to be reduced immediately as more uninsured people gain coverage.”

Dr. Punch agrees, telling the Michigan Messenger, “While it still seems difficult to me to predict what might happen with health care reform, any move to assure insurance coverage for pregnant women and provide adequate reimbursement to hospitals and physicians for taking care of them would certainly have a positive effect on minimizing the number of physicians and hospitals pulling out of providing obstetrical coverage for the women of Michigan.”

If Stupak’s insistence on not voting for the health care reform bill if it does not include his anti-abortion language succeeds in derailing that bill, it may well be the women of his own district — and their infant children — who suffer as a result.