One possible benefit of the Affordable Care Act that has been surprisingly little discussed is its potential impact on America’s appallingly high infant mortality rate. But as Eduardo Porter reported earlier this week in the New York Times, some experts believe the ACA could have a powerful impact.
There’s no question that America’s infant mortality is scandalously high. It is, in fact, the highest of any economically advanced country — well over twice as high as the rates in countries like Japan and Portugal, for example. Shockingly, the only OECD countries with higher infant mortality rates are Mexico, Chile, and Turkey, all of which of course are far poorer countries than the U.S.
Porter says that the reasons for our high infant mortality rate appear to be complex, but one of the most basic ones is that many women lack adequate, or any, health insurance. For instance, Porter notes that individual insurance policies usually don’t cover maternity care. Medicaid has covered poor women, but in most cases only while they are pregnant and for a few weeks after.
Do you think, maybe, that a health care policy that treats women not like breeding cows but like inherently valuable human beings, and that makes it easy for them to access health care even when they’re not pregnant, might improve their health, and subsequently their newborns’ health as well? Seems reasonable, if you ask me.
Another thing that would seem like a no-brainer to me is that anti-choice groups would strongly support the ACA. After all, they got their way, and the Act does not expand women’s access to abortion. But it will expand women’s access to affordable health care, which could lead to major improvements in the health not only of women but also of the infants they give birth to.
Anyone who’s studied anti-choice activists know that they are utterly unconcerned about women’s well-being — except to the extent that a woman is the vessel for another human life. But even given those severe limits, you’d think they’d support the ACA, if only because they’re always ranting about dead babies. The savage inequities of the American health care system manage to produce quite a lot of dead babies — some 25,000 infants die every year in the U.S.
A health care reform that looks as if it might significantly reduce the carnage would appear to be something a pro-life activist would favor, by definition. That is, you’d favor it if, in reality, your “pro-life” identity was a serious ethical and political commitment, instead of a cheap political slogan you exploited to cover up your perverted obsession with controlling women’s bodies and sexuality.
All of which brings me to Irin Carmon’s very interesting MSNBC.com piece about a split in the Ohio anti-choice movement. Two Ohio antichoice groups, Right to Life of Greater Cincinnati as well as Cleveland Right to Life, have filed suit to prevent the state’s Republican governor from expanding Medicaid — even though the expansion would not affect abortion services, which are not covered. At the same time, Ohio Right to Life, a statewide group associated with the National Right to Life Committee, supports both ACA and the Medicaid expansion. (National Right to Life has not taken a position on ACA or Medicaid expansion).
The reasons why the Cleveland and Cincinnati groups are opposed to ACA and Medicaid expansion include the usual boilerplate — that the programs would provide access to forms of contraception which these groups (falsely) claim are “abortion-inducing.” But there’s also this revealing bit of viciousness, which doesn’t even make the pretense of having anything to do with abortion:
So why oppose more poor people getting health insurance coverage? “What Medicaid expansion will do is place thousands of people on the rolls that are able-bodied, primarily men, and that opens up a whole another can of worms for disincentives for work and healthy lifestyles for these people,” said [Right to Life of Greater Cincinnati executive director Paula] Westwood. She pointed out that Ohio’s Medicaid program automatically enrolls pregnant women who meet the income requirements, as well as their children until age 18. For low-income mothers themselves, that coverage currently ends a few weeks after giving birth.
As an example of how the program would change if Medicaid were expanded, Westwood cited a restaurant worker without employer-provided insurance being covered on Medicaid. Wasn’t that person already working? “I’m not going to get into specifics. I’m not trying to go after restaurant workers,” said Westwood.
I don’t know about you, but that sounds like straight-up class warfare to me. As to why having affordable health care might be a “disincentive” to a healthy lifestyle, your guess is as good as mine. But clearly we’re not dealing with the Oxford Debating Society here.
What I find intriguing about Westwood’s remarks is how representative they are of the seamlessness of wingnut ideology. Asked about why her group opposes expanding Medicaid, the very first thing out of Westwood’s mouth (it’s preceded by “First of all” in Carmon’s piece) is not anything that even tries to make a connection to abortion. Instead, we get a rant about shiftless welfare dependents.
Westwood seems to assume that if you subscribe to one right-wing belief (abortion should be illegal), then you’ll order the entire combo platter as well. Against abortion? Then of course you must be against universal health care and generous social welfare benefits, too! (Quick, somebody tell Pope Francis!).
The other fascinating thing about Carmon’s piece is that is Ohio Right to Life is opposing the other right-to-life groups. In actively supporting Medicaid expansion and the ACA, not only is it taking a stance in opposition to the other local groups, it’s taking a different position from National Right to Life as well. (National RTL, as I mentioned, has taken no position on these issues). I wonder if the split is something peculiar to Ohio or if it’s a hint that a more serious division in the antichoice movement is developing.
One possible way a split could play out is that some groups with an evangelical Protestant base will stay loyal to the G.O.P. and take a hard line against expanded social welfare programs. Other groups with more of a Catholic base might start listening to what Pope Francis is saying about the evils of inequality and the importance of helping the poor. They might be more willing to support universal health care, or increasing TANF benefits.
To the extent a split might occur, I’m guessing that it won’t prove serious. Antichoice activists are among the most hardcore supporters of the G.O.P. Voters who are social welfare liberals but lean right on abortion are rare. American antichoice activists who are genuine social welfare liberals are, in my experience and to my knowledge, nonexistent. Still, the split in the antichoice movement in Ohio comes as a surprise, and it bears watching.