The Washington Post

During two-year window, D.C. covered costs for 300 abortions for low-income women

WASHINGTON — For decades Congress has used its power over the District of Columbia to ban the city from paying for abortions for poor women, but during a two-year period when lawmakers reversed course at least 300 women got city-funded procedures, according to data obtained by The Associated Press.

That period when the city was free to pay for abortions ended earlier this year. The city now says that during that time it spent approximately $185,000 providing elective abortions for poor women who receive health care through government programs. The number of women who got abortions and their cost was provided by city officials after AP filed a Freedom of Information Act request.

Officials in the heavily Democratic city have sparred for years with Congress over the city’s ability to cover the abortions with taxpayer money. During brief periods when Democrats have had control of the House, Senate and presidency, the city has been able to pay for them, but that ability has been taken away when Republicans and Democrats have shared power. The back-and-forth over the procedures is part of an ongoing struggle between local officials and Congress over control of city affairs.

In May, Mayor Vincent Gray reported to Congress that the city had paid about $62,000 to provide 117 abortions to women whose health care was covered by Medicaid and the D.C. HeathCare Alliance, programs serving low-income residents. The mayor’s office said Thursday in an email that the discrepancy reflects the fact bills were not submitted on time, but that 300 procedures was the correct number. City spokeswoman Doxie McCoy said that the exact number of abortions the city paid for could still rise because claims are still being processed.

Wayne Turnage, director of the D.C. Department of Health Care Finance, has told The Washington Post that the 117 figure did not included abortions billed by one of the managed-care organizations that have contracts with the city. Unison Health Plan had yet to submit its billings for the period since abortions were first covered. Also: Those billings still have to pass a adjudication process, where the claims are scrutinized by city overseers.

Many private insurance plans do cover abortions, and women who have coverage through their employers can use that to obtain an abortion in the District of Columbia. But that’s not true for the city’s poor.

More than a third of the city’s some 600,000 residents get health care through Medicaid or the D.C. HealthCare Alliance. That has meant that when Congress has prevented the city from covering abortions, poor women seeking them have had to come up with hundreds of dollars for the procedures themselves. A non-profit group called the DC Abortion Fund will help defray some or all of the cost, as will the city’s chapter of Planned Parenthood, but the women still generally have to come up with a portion of the expense.

DC Abortion Fund president Tiffany Reed said being able to use a Medicaid card made getting an abortion easier for a poor woman than at any other time. Laura Meyers, chief executive officer of Planned Parenthood of Metropolitan Washington, D.C., said it also gave the woman dignity. Now, she said, women often have to cobble together funds from multiple sources, which may take time and mean getting an abortion later, increasing her health risk.

“It’s about scrambling now: ‘How do I get the money to pay for my abortion?’” said Meyers, whose organization was one of those that briefly provided abortions to women using Medicaid.

Data from the city’s Department of Health Care Finance shows it took more than a year for the city to begin paying for abortions once Congress lifted its ban in December 2009. The first abortion paid for by the city was provided in August 2010, the last four on April 13, 2011, the day before lawmakers voted to reinstate the ban. The majority of the procedures cost about $500 or $700.

Congress’ control over Washington’s affairs puts it in a unique position on abortion funding. Like all states, Washington has been prohibited by Congress since the 1970s from using federal money to pay for abortions for women on Medicaid except in cases of rape, incest, or to protect the life of the mother. But states can use their own tax dollars to pay for the procedures for women on Medicaid if they wish. Currently, 17 states use their own money to pay for abortions for women on Medicaid, though all but four do so under court order.

Because Congress oversees the District of Columbia’s affairs and approves its budget, Capitol Hill lawmakers have the final word on the matter in the city. Since 1988, members of Congress have attached a so-called “rider” to the city’s budget nearly every year banning the city from using its tax dollars to fund abortions, in opposition to city lawmakers’ wishes. The ban was lifted briefly once before in 1993-1994.

Lawmakers lifted the ban again in late 2009 when Democrats controlled both houses of Congress. But the change was short-lived. With a new Republican majority in the House in 2011, Congress re-imposed the ban in April.

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