Bloomberg News

Curbing Female Reproductive Rights Raises Taxpayer Costs

April 03, 2012

Supporters of health care reform rally in front of the Supreme Court in Washington on March 28, 2012. Photographer: Charles Dharapak/AP Photo

Supporters of health care reform rally in front of the Supreme Court in Washington on March 28, 2012. Photographer: Charles Dharapak/AP Photo

Celeste Warden takes night classes at a local community college as she works toward a bachelor’s degree, and she’s got a job earning $14,000 a year at a local non-profit. She helps care for her elderly parents, owns a white Nissan Versa and has built up $1,000 in savings.

Warden is convinced she would have achieved little of that had she not had an abortion in 2007, when she was an unwed, 29- year-old woman with neither a college degree nor a steady job.

“I couldn’t have cared for a child -- I was having a hard time at that point caring for myself,” she said in an interview.

As restrictions on abortion and contraception have become the subject of state legislative action and Republican presidential candidates’ pitches to voters, arguments have focused on the issue’s moral and religious dimensions.

Less attention has been paid to the financial implications to states, businesses and women if governments impose policies that lead to increases in unplanned or unwanted pregnancies. The economic ramifications of such policies are important as the nation recovers from the worst recession since the Great Depression and governments work to reduce debts and deficits.

“There’s a simple math in place: more unintended pregnancies mean more public costs,” said Bill Albert, chief program officer at the National Campaign to Prevent Teen and Unplanned Pregnancy. “Especially for the deficit hawks, it is a penny-wise-pound-foolish strategy.”

Value of Life

Kristi Hamrick, a spokeswoman for Americans United for Life, a Washington-based legal organization that seeks to overturn abortion rights, rejected that conclusion, saying the value of life can’t be reduced to dollars and cents.

“The unknown and absolute value of life is clear in what a person brings to society,” Hamrick said. “Let’s look, for example, at a girl who gets pregnant in college, does marry the father of her child, works to raise this child, and he becomes president. That’s Barack Obama,” she said, in a reference to the life experiences of the president’s mother.

About 49 percent of pregnancies in the U.S. are unintended, compared with 33 percent in France, according to data compiled by the New York-based Guttmacher Institute, which studies abortion trends.

Medicaid Costs

In Oklahoma, where Warden, 34, resides, Medicaid paid for the treatment and delivery costs for more than 70 percent of the 26,100 unintended pregnancies in 2006, the only year for which state-by-state data is available, according to Perspectives on Sexual and Reproductive Health, a peer-reviewed journal published by the Guttmacher Institute.

For the Sooner State, which had the 10th-highest percentage of such births among states that year, the price tag for prenatal and post-partum care for the woman and infant was $55.6 million while the federal government’s share of those costs was $117.6 million. Nationwide, federal and state government costs for treating and delivering unintended pregnancies in 2006 was more than $11 billion.

The National Business Group on Health, which helps large employers structure health benefits packages, reports that most of its 346 members include contraception because it saves money. Employers who cover birth control, at an average cost of about $39 per female employee per year, end up saving about $9,000 per female employee in any two-year period compared to those who don’t, according to a report from the nonprofit, which doesn’t take political positions.

“Contraceptive coverage translates to lower costs,” said Debbie Harrison, the senior public policy manager for the group.

Family Planning Savings

Publicly-funded family planning services save state and federal governments $4.3 billion each year, according to the National Campaign to Prevent Teen and Unplanned Pregnancy. Contraceptive use saves almost $19 billion in direct medical costs annually and reduces the occurrence of abortion, according to the campaign, a Washington-based nonprofit.

The effects of an unintended pregnancy on women are both personal and financial.

A disproportionate share of women who experience unplanned pregnancies are teenaged, unmarried or low-income with higher incidences of mental illness, unstable relationships, physical abuse and welfare assistance, said Adam Thomas, a visiting assistant professor at Georgetown University’s Public Policy Institute in Washington. Expanded access to contraception, meanwhile, increases educational attainment and labor force participation, he said.

Improved Lifetime Earnings

A woman with a bachelor’s degree on average earns $1.9 million during her working lifetime, 73 percent more than a woman with a high school diploma, whose average lifetime earnings are $1.1 million, according to a 2011 report by Georgetown University’s Center on Education and the Workforce.

“It doesn’t matter where you stand on abortion,” said Albert. “At the very least, efforts to restrict abortions should at least be coupled with stronger efforts to help women avoid unplanned pregnancies, but that is rarely the case.”

Proponents of restrictions on some forms of birth control and abortion rights say their positions also have economic upsides.

Tony Lauinger, chairman of the Tulsa-based non-profit Oklahomans for Life, said the shrinking number of workers paying for the Social Security benefits of retirees could “absolutely” be solved by banning abortion.

“We would argue that our nation would be a healthier nation, a stronger nation, we’d have a stronger economy if we hadn’t aborted 54 million potential taxpayers over the past 39 years,” he said in an interview at the snack bar in the statehouse.

‘Personhood’ Legislation

Oklahoma is one of 38 states this year in which legislators have introduced bills restricting access to abortion, including a measure that would declare fertilized eggs as persons -- a proposal that may have taken away Warden’s choice of an abortion. Bills to curb access to family planning services have been introduced in 16 states.

The so-called “personhood” legislation comes after states passed a record 92 provisions restricting abortion rights in 2011, according to Guttmacher, whose data is used by both sides of the abortion debate even as the organization favors greater access to the procedure.

At least eight states reduced state funding for or access to family planning last year. Clinics providing birth control, tests for sexually transmitted diseases and screenings for breast and cervical cancer closed in Texas after lawmakers reduced funding by 66 percent, to $38 million from $111 million, even though they didn’t perform abortions. That is also the case in New Jersey, after Governor Chris Christie line-item vetoed about $7 million last year for the second year in a row.

Oklahoma Abortion Restrictions

When Warden had her abortion in 2007, Oklahoma already mandated counseling, a 24-hour waiting period and parental notification and consent for minors.

The decision “enabled me to not have to rely on government assistance and to pursue an education so I can do something to better where I live instead of being a burden,” she said, noting that she probably would have needed government housing, food and day-care assistance.

Since then, state lawmakers have made illegal abortions after 20 weeks post-fertilization based on the presumption of fetal pain. They also barred health plans -- including private companies -- participating in the Affordable Care Act’s insurance exchange from covering the procedure unless a woman’s life is endangered.

Court Challenges

An Oklahoma law imposing new requirements for women taking the so-called abortion pill has been enjoined by courts, and another mandating ultrasounds for women seeking abortions was struck down as unconstitutional on March 28. The number of abortion providers in the state has fallen to 3 from a high of 18 in 1982.

Those laws helped Oklahoma earn second place, just behind Louisiana, in Americans United for Life’s “Life List” last year. The list highlights states “leading the way to a more pro-life America.” The group called 2011 “a watershed year in the defense of life” and said “2012 holds equal promise.”

The latest proposal before the Oklahoma legislature, S.B. 1433, would endow fertilized eggs with the rights, privileges and immunities accorded to those already born and builds on nationwide efforts to codify into law the separate status of fetuses, most often in the context of criminal statutes.

Opposition Mobilizing

The American Civil Liberties Union, state medical groups and Planned Parenthood oppose the bill, warning that the version passed by the Republican-led state Senate in February would ban abortion for all women, even those whose lives are at risk or are rape victims, and outlaw some forms of birth control. It has since been amended to include exceptions for birth control and in-vitro fertilization and awaits a vote in the Republican-led House.

Lauinger said the legislation is a written “commitment to life” and modeled after a similar Missouri statute from the 1980s that hasn’t criminalized abortion. He instead points to the bill’s “educational value.” Even if the bill fails, the issue could appear on a statewide ballot this fall.

Ryan Kiesel, a Democrat who served in the legislature from 2004 to 2010, disagreed, saying nothing in the proposal “would prevent a court or local hospital from acting against the interest or the will of a pregnant woman.” Kiesel is executive director of the ACLU’s state chapter.

Warden, meanwhile, said that while her decision was an “emotional” one, she doesn’t regret it.

“I’m grateful for the fact that I had the choice because financially, spiritually, emotionally, there was no way that a child had any place in my life,” she said.

To contact the reporter on this story: Esmé E. Deprez in Oklahoma City, Oklahoma at edeprez@bloomberg.net

To contact the editor responsible for this story: Stephen Merelman at smerelman@bloomberg.net


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