Ariana B. Kelly, a Democrat, represents Montgomery County in the Maryland House of Delegates, where she is vice chair of the Health and Government Operations Committee.
As we took on these preparations, our vision was to use this unwanted opportunity to improve reproductive health outcomes. We committed ourselves to reducing geographic and racial health disparities and fighting back against the shame and stigma antiabortion extremists have been burdening women with for decades.
In short, we asked ourselves: Can we just start treating abortion services like health care? It is an idea that is so radical and yet so simple.
With the Abortion Care Access Act of 2022, which I introduced with state Sen. Delores G. Kelley (D-Baltimore County), Maryland legislators used all the same tried-and-true strategies we have employed to make our state a leader in equitable health-care access for decades. We invested in training a geographically and racially diverse health-care provider network, ensured people could practice at the top of their professional licenses and reduced financial barriers to care.
We mandated that insurance and Medicaid cover abortion, and, as with other preventive services, we required abortion care to be fully covered with no cost-sharing. Eliminating deductibles and co-payments means women can access the care they need when they need it. Gone will be the days when patients had to wait several pay periods to save up enough funds for their abortion care.
Women who use Maryland Medicaid will never again have to go through a humiliating and stigmatizing process to justify their abortion. And their rights won’t be up for debate year after year in the budget process. Because, in Maryland, we don’t treat low-income women as lesser human beings. We know they have the same right to reproductive choices as any individual with private insurance, and our state policy now reflects that.
Modernizing insurance and Medicaid laws around abortion has the added benefit of supporting out-of-state women. If Maryland women no longer need charitable support to help cover their costs because insurance is doing its job, that frees up nonprofit abortion funds to help with travel costs and other expenses for our neighbors.
Throughout the debate on Maryland’s Abortion Care Access Act, our bill’s opponents demonized abortion providers. It’s not politically winning to cast the blame on women seeking abortion care (everyone loves someone who has had an abortion), so the boogeymen became the evil “abortionists” who are just out to make money manipulating women into wanting abortion care.
We would not stand for that in Maryland. As the nation emerges from the coronavirus pandemic, with tremendous gratitude for health-care heroes (76 percent of whom are women), we followed their lead on how to address the looming onslaught of out-of-state patients. We didn’t want to just maintain the status quo for in-state patients; we wanted to do even better.
The new Maryland model will allow women to receive abortion care in their community from health-care providers they already trust. Today, two-thirds of Maryland counties have no abortion providers. Many women must drive hours to seek clinic-based care in the Baltimore-Washington corridor. Within a few years, every county in Maryland could have a trained primary-care or reproductive-health-care clinician who provides abortion care, significantly increasing access to care and reducing stigma.
How will we do this? With the strong support of Maryland’s obstetricians and gynecologists, our bill eliminated a decades-old restriction that said you had to be a physician to provide abortion care in Maryland. This opens the doors for the provision of abortion care by nurse practitioners, nurse midwives and physician assistants. These are the same health-care providers already providing labor and delivery, contraception and primary-care services across the state.
We also created a clinical training fund. Maryland will invest $3.5 million annually in making sure licensed health-care providers who want to provide these services are trained to do so. This will be critical in the aftermath of the court’s decision, when an estimated 44 percent of obstetrician/gynecologist residents nationwide could lose access to abortion-care training through their educational programs. This training program will be open to providers from across the region, not just in Maryland. We hope other pro-choice states follow our lead in helping to fill this critical gap in health-care education.
In Maryland, we care about all mothers and babies. That’s why we have worked relentlessly to reduce health disparities and improve healthy birth outcomes. That’s why we are strengthening our commitment to the full range of reproductive health-care options and are standing up to help our neighbors. It’s also why we invested this year in paid family and medical leave for people who choose parenting or adoption.
Interestingly, 100 percent of the “pro-life” Republican opponents of the Abortion Care Access legislation also opposed this maternity leave bill. With some people, women just can’t win.