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Rhode Island fails to guarantee abortion access, affordability

F grade draws attention to changes to health insurance exchange under new governor

NARAL Pro-Choice America — a national reproductive rights advocacy group — awarded Rhode Island an F in January in its annual scorecard of states’ reproductive freedom. The ranking puts Rhode Island in the same company as Texas and South Carolina. Rhode Island had received a D+ grade the previous year.

The ranking was based on a variety of factors, including restrictions placed on young, low-income women and the fact that 80 percent of Rhode Island counties do not have access to an abortion clinic, according to the report.

In an effort to discuss threats to reproductive freedom in Rhode Island and across the country, a “reproductive freedom teach-in” was hosted by the Planned Parenthood of Southern New England, the R.I. Coalition for Reproductive Justice and Brown Medical Students for Choice at Rhode Island College March 2.

Reproductive freedom “is not an issue in other parts of the country,” said Craig O’Connor, director of policy and advocacy at Rhode Island’s Planned Parenthood. “It’s a problem here in Rhode Island.”

The event coincided with the first day of oral arguments in the Supreme Court case Whole Woman’s Health v. Hellerstedt, which was discussed heavily by the event’s panelists.

“What we have now is an anti-movement,” said Pablo Rodriguez, president and CEO of Women’s Care. “It is using the courts and legislature to put obstacles in front of women, and they’re winning,” he added.

“In Rhode Island we are an F. We are not that far from Texas,” said Amy Retsinas Romero ­­— president of Women’s Health and Education Fund, an organization providing financial assistance for women seeking abortion — at the teach-in. “We should all be ashamed of ourselves.”

Pro-life advocates question the credibility and impartiality of NARAL. “They are the folks most responsible for the legalization of abortion in 1973,” said Barth Bracy, executive director of Rhode Island Right to Life, adding that NARAL was originally named the National Association for the Repeal of Abortion Laws. “They are an abortion industry player with their own agenda, which is to expand abortion.”

Bracy finds fault with the motives of NARAL. “They disagree with things like parental consent,” he said. “Their policies are extreme and not supported by the majority of Americans.”

Obstacles to abortion

The Whole Woman’s Health case is especially relevant in Rhode Island, a state that does not in its own right guarantee women access to abortion. In fact, the state explicitly denies the right to abortion in its constitution, which was amended in 1986 to include the assertion that “nothing in this section (Article I Section II) shall be construed to grant or secure any right relating to abortion or the funding thereof.”

That insert means that if Roe v. Wade is overturned in the future — as it could be in the Whole Woman’s Health case — there will not be a guaranteed right to abortion in the state of Rhode Island.

Romero discussed a number of issues in her address, including the cost of obtaining an abortion in a state where the procedure — which costs on average $500 but could potentially cost thousands of dollars — is not funded by Medicaid except in cases involving life endangerment, rape and incest.

A change made to the rules of the state’s health insurance exchange, HealthSource RI, also resulted in the loss of insurance coverage for abortion for 9,000 people, said Steven Brown, executive director of the Rhode Island chapter of the American Civil Liberties Union.

“(Gov. Gina) Raimondo made some changes in an effort to get the health insurance exchange funded,” said Sen. Gayle Goldin, D-Providence.

Insurance carriers participating in the exchange are now required to offer at least one plan at each tier of coverage — bronze, silver and gold — that does not cover abortion beyond the federal minimum requirements. Subscribers’ insurance plans are automatically renewed, meaning that those not actively seeking abortion coverage lost it. The change in rules was mandated by the state health insurance commissioner.

While many criticize Raimondo for the loss of coverage offered to women seeking abortion, Bracy does not believe that the majority of cases warrant an abortion. “Well over 90 percent, maybe even 97 percent are what are often called ‘elective abortion,’” he said, adding that cases of rape and incest account for as little as 3 percent of abortions. “What I like to do is stick with the reality of what we’re working with and not look at the minority of cases.”

In this context, Bracy does not view an F grade from NARAL as gravely as others would. He noted that the grade change was a result of alterations to insurance funding for abortion that allowed people to choose whether or not they wanted plans that covered abortion. “They dropped Rhode Island from a D to an F because they gave people choices,” he said.

Additionally, abortion coverage is not offered to state employees nor is it granted in relation to fetal abnormalities that are “usually late-term and very expensive,” Romero said. “We don’t want any women to turn to other measures if they can’t get an abortion,” she added.

Another policy critiqued in the teach-in was Rhode Island’s spousal consent law, which requires a woman seeking an abortion to inform her spouse of her decision. Though rendered unconstitutional by federal court decisions, the law remains on the books and could be enforced again if cases like Roe are overturned in the future.

Mixed-choice democrats

It can be difficult to understand how developments warranting Rhode Island’s F rating are possible in a state that has had a unified Democratic majority in the General Assembly for over a decade in addition to two Democratic governors in a row.

“Nationally the party is pro-choice but Rhode Island Democrats are different in that regard,” said Rep. Edith Ajello, D-Providence. Both chambers of the Rhode Island General Assembly are anti-choice, she added.

“We have a set of laws that restrict(s) a woman’s capacity to make her own decision,” Goldin said. Goldin noted that many of the laws have been in place for years, but the demotion from NARAL may be attributable to alterations under Raimondo’s first term in office.

Though she ran as a pro-choice candidate, NARAL lists Raimondo as “mixed-choice,” indicating a disputed record on reproductive rights.

Marie Aberger, Raimondo’s press secretary, defended her record in an email to The Herald, writing succinctly that “Raimondo is and always will be pro-choice.”

“I wish she were,” Brown said, “but it was her proposal that led to the removal of abortion coverage from those plans,” referring to the change in rules for HealthSource. He added that the loss in coverage for so many Rhode Islanders “may or may not have been the intent, but it was the result of legislation that she proposed.”

Future of reproductive rights

“We’ve introduced legislation to repeal some of the stuff on the books, but it’s gone nowhere,” said Ajello, who is heading an effort to codify Roe v. Wade into Rhode Island law. Codifying the Roe decision is critical for pro-choice politicians because “should it be weakened or overturned by a future federal court, … Rhode Island law would be stronger,” Ajello said.

“There are many cases we could make in the legislature,” Goldin said, explaining that, as a legislator, the most important path for her is “to try and increase access by removing barriers, as well as trying to remove some of the unconstitutional language from the law.”

But without larger pro-choice support, it will be an uphill battle for politicians like Goldin and Ajello seeking to better Rhode Island’s record on reproductive freedom. The past voting record of the General Assembly may, consequently, necessitate action beyond the political forum.

“It’s redressable through constituent pressure,” Brown said, explaining that it is the responsibility of citizens to contact their legislators and “urge them to take action to strengthen reproductive rights and prevent any more regression.”

“We need to talk about why we got that F and what we can do about it,” O’Connor said. “We need to realize that our rights really are at risk.”


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