Oregon’s healthcare lottery

Ugh. This is horrible in so many subtle and multifaceted ways. For me, it immediately brings up flashbacks of doing options counseling and helping broke women and girls figure out how they were going to pay for an abortion.

Four hundred and thirty dollars is the (already heavily discounted) rate. PP has an abortion fund, but it’s limited, so they impose restrictions to keep the money from running out — the fund pays $215 at most, and you must first be rejected from OHP (or DSHS medical in Washington) to qualify.

Thus, we referred a lot of unemployed women to OHP…and women dependent on abusive partners…and scared and bewildered teenagers who didn’t even understand what health insurance was, much less how to effectively navigate tangled social service bureaucracies…the list goes on. Some of their applications were accepted. If they were denied, they could come into our clinics and fill out still more paperwork to apply for the PP fund; however, many never made it that far.

A key insight about social services: Every extra step imposed between a person and a service they need — every confusing piece of paperwork, every delayed or redirected telephone call, every demand for documentation — decreases the chance they will actually get the service. The barriers may appear trivial, but they are often effectively insurmountable for the people who are deepest in crisis. Many people do not have the education, or the persistence, or the optimism to make it through. People give up. Often they feel that their lives are unmanageable and don’t have faith in the government’s ability to help.

Anyway, I’m curious what will happen now that OHP is going to a lottery system — will the PP fund buckle under increased demand, or will it remain semi-unscathed because people will be too discouraged to even apply for it? Awesome options there! HIGH FIVE, PEOPLE!

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The thing that’s really fucked is that the citizens of Oregon (and Washington) still have it far better than many other US states, where Medicaid is legally prohibited from funding abortion services and where abortion clinics are scattered 500 miles apart. A woman five hours’ drive from the nearest abortion clinic who’s working for minimum wage can’t get any financial help to end an unwanted pregnancy in many states…but all 50 of them will cheerfully sink hundreds of thousands of dollars into 18 years of health care for her and her future child!

This is why many people are pissed off and alienated by middle-class feminism’s arguably-myopic focus on upholding Roe v. Wade. I don’t think anyone would claim that Roe v Wade isn’t important, but it’s also crucial to recognize that many women in this country are effectively barred from safe legal abortion regardless of supreme court precedent because of economic/geographical constraints. In order to promote reproductive freedom for everyone, including the people who are most likely to be financially crippled by unwanted kids, we need to focus on access as well as legality. Of course that’s way more difficult, since it implicates the entire set of safety nets our country provides (or, y’know, fails to provide).

Sigh. I really need to find a more productive way to channel this. In the meantime, I will leave you with this other article, Why I am an Abortion Doctor, which got me all choked up when I read it soon after quitting PP (although YMMV).