NPR reports on a study by Ibis Reproductive Health on the exceptions to the Hyde Amendment, which turns 35 years old this month. To no one's great surprise, I'm sure, women who qualify for Medicaid-funded abortions because of rape, incest, or medical necessity usually don't get Medicaid to pay for it. In fact, I was surprised at how many women were able to finally get their funding: 37 percent of abortions that qualified for Medicaid reimbursement because the women were rape victims or because of the health exception did result in Medicaid ponying up. Still, this means that in 63 percent of rape or health exemption cases, women pay out of pocket, a non-profit covers it, or doctors provide the abortion for free.
The difficulty in getting Medicaid coverage for cases that qualify under the law as written demonstrates why building exceptions into abortion bans just doesn't work. The whole idea behind the "rape, incest, or medical emergency" exception is that the law can meaningfully divide women into virgin and whore categories, and allow the former to have the abortions they've earned by being good girls in pitiable situations (including women who fully intended to have their babies like good, Christian women, but who face health problems that prevent them from doing so) while making sure the filthy sluts who have sex for pleasure get their due punishment. But the categories of "virgin" and "whore" aren't as clear-cut as people who come up with these exceptions imagine. Anyone who observes the justice system's approach to rape can attest to this; behavior in the victim that may have seemed relatively innocuous before the rape suddenly looks like the height of dirty sluttitude when portrayed by the defense team, allowing juries to let accused rapists off because the victims were supposedly asking for it. (I got a powerful photo at SlutWalk NYC demonstrating how silly all this really gets.) Exceptions for how you got pregnant in abortion bans allow the person making the exception to preen about how they aren't trying to punish the good girls, but in reality almost no one gets to be a good enough girl to be considered a good girl. After all, we still have vaginas and sexual urges, exactly like those filthy sluts. The lines blur quickly.
Most women who need abortions fall somewhere between the wanton harlots and virginal rape victims of the anti-choice imagination. Take the former president of NARAL, Kate Michelman, who was put on the road towards pro-choice activism after her husband left her suddenly while she was pregnant and caring for three small children. Does her abortion count as a harlot one or a good girl one? By any measure, she was trying to live the life that Christian fundamentalists lay out for women---chaste housewifery complete with a large family---and still she found herself in a situation of needing an abortion. What about a teenage girl who is trying to use contraception, but her insecure and abusive boyfriend sabotages it in order to get her pregnant so he can control her? Believe it or not, it's a surprisingly common problem. These girls often fall short of being rape victims, but they are absolutely being coerced into pregnancy that they don't want and are trying to prevent. In many cases, they are in more desperate and wretched circumstances than someone who is randomly raped once and becomes pregnant, but they don't get one of those precious rape exceptions.
Rape exceptions are there to relieve anti-choice consciences more than they are there to make sure women in need get abortions. They demonstrate the futility of having outsiders who don't understand a woman's intimate situation trying to parse whether or not she deserves an abortion, whether or not she's put enough of a good faith effort into fitting their model of chaste womanhood to get the abortion she needs. Letting women determine for themselves whether or not they need an abortion is a far more efficient and fair system; after all, they know better than perfect strangers the incredible complexity of their personal situations that determine whether or not it's a good time to have a baby. This right exists for women who can afford to pay for their own abortions; it should be extended to women who depend on assistance to pay for their medical care.