L.D. 820 Testimony

TESTIMONY OF THE MAINE MEDICAL ASSOCIATION

IN SUPPORT OF

L.D. 820, AN ACT TO PREVENT DISCRIMINATION IN PUBLIC AND PRIVATE INSURANCE COVERAGE FOR PREGNANT WOMEN IN MAINE

Joint Standing Committee on Health Coverage, Insurance & Financial Services
Room 220, Cross State Office Building, Augusta, Maine
Wednesday, March 27, 2019, 1:00 p.m.

All Maine women deserve the full range of reproductive health care and according to the American Academy of Obstetricians and Gynecologists (ACOG) “Safe, legal abortion is a necessary component of women’s health care. (ACOG) supports the availability of high-quality reproductive health services for all women and is committed to improving access to abortion.” ACOG recognizes abortion as an integral component of women’s healthcare1.

Good afternoon Senator Sanborn, Representative Tepler, and Members of the Joint Standing Committee on Health Coverage, Insurance & Financial Services.  My name is Norma Dreyfus, M.D. and I am a retired pediatrician from Arrowsic and I am pleased to be here to testify in support of L.D. 820, An Act to Prevent Discrimination in Public and Private Insurance Coverage for Pregnant Women in Maine on behalf of the Maine Medical Association.  I am a long-term member of the MMA Legislative and Public Health Committees. 

This bill seeks coverage for abortion services, as determined in accordance with the law and in keeping with the recommendations of the treating physician in all public and private health insurance programs, including MaineCare.  Abortion in Maine is legal and safe but is not available to all women.  The cost simply puts it out of reach for many low-income women.  Health care decisions in pregnancy should be made privately by patient and clinician and should be based on the best interests of the patient and her family, not the patient’s or her family’s financial circumstances.  Public and private insurance coverage for abortion care should be covered no differently from all other essential health care services.  It’s a woman’s right to decide if to have children, when to have children and the spacing between those children. 

In the United States, one half of all pregnancies are unintended and 1 in 3 women seek an abortion by age 45.  Many factors influence a woman’s decision to have an abortion.  It may be contraceptive failure, barriers to contraceptive access, rape, or partner abuse among others.

Although the greatest number of abortions are performed on women who already have children, adolescents are also at risk for unintended pregnancy.  No birth control method is fool-proof and adolescents are especially vulnerable to forgetting.  Newer methods of birth control like the long acting reversible contraceptives may not yet be available to many.

As a physician who took care of adolescent patients, I am reminded of my teenage patient from a low-income family in which none of the members had gone to college, who was at the top of her class.  She had been accepted to the college of her choice but her goals and ambitions were thwarted by an unintended pregnancy.  She came to my attention later in her pregnancy.  She had not had the means to have an abortion and as a result her life trajectory took a dramatic turn.

Women have had abortions throughout the centuries.  I recently attended a lecture at Bowdoin College on abortion networks that existed in France during the reign of Louis XIV.  Abortion is as much a component of health care as all reproductive health and we need to remove barriers that make it inaccessible for some women.  Whereas legal abortion has been shown to be extremely safe, if access is unavailable because it is unaffordable, some women may resort to unsafe and illegal methods.

Research and experience show that when abortion is not available, desperate women may turn to means which include self-inflicted trauma or the consumption of dangerous chemicals.  Some turn to untrained unsafe abortion providers.  I witnessed the results of this in the 1960s as a medical student where there was an entire ward filled with just women who had suffered illegal or self-induced abortions.  Many of these women died.  Those who lived were all traumatized and most were sterile.

It is important to make safe, legal abortion available to all women in Maine and removing the financial barrier is a key to achieving this goal.  As an integral part of our reproductive health care system, abortion care should be covered by public and private health insurance.

I ask that you vote “Ought to Pass” on L.D. 820.  Thank you, and I would be happy to respond to any questions you may have.

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1Increasing Access to Abortion. Committee Opinion No 613. American College of Obstetricians and Gynecologists. Obstet Gynecol 2014;124;1060-5