An Open Letter to Sen. Joni Ernst

Dear Senator Ernst,

I am writing to ask your support for having the Senate hold deliberate, open hearings from experts in health care prior to any further legislation repealing, replacing, or revising the Affordable Care Act (Obamacare). I am gravely concerned that political and fiscal interests are taking precedence over health and moral outcomes. In particular, I think there is a particular issue regarding pro-life goals--a position you and I both share.

In the mid-’90s in Atlanta, I was briefly on individual plan insurance. I was in my 20’s and a perfectly healthy woman. Kaiser Permenente was the best insurance available to me. The monthly premiums for healthy individuals my age were (to the best of my recollection) $30 for men, $90 for women, and $130 for women who wanted maternity coverage. There was also no contraception coverage in these plans. The contraceptive pill cost $39 a month. Abortions at the time in the local clinic cost $450 in cash. To give you some perspective, my rent at the time was $450 a month, and I lived in a very impoverished part of town in an efficiency apartment.

At the time, I wasn’t planning on needing contraception, but as a sexual assault survivor, I knew that even a commitment to chastity didn’t necessarily mean a single girl couldn’t get pregnant. I marveled how the insurance system that I was participating in actually had a financial incentive for women to have abortions rather than either preventing pregnancy with contraception or covering maternity care for all women. A healthy pregnancy and delivery could cost $10,000 in out-of-pocket care without a maternity rider, a maternity rider cost $480 per year, the contraceptive pill was $468 per year, and the abortion was $450.

We cannot go back to the Wild West days of health insurance, which is what will happen with a repeal of ACA without an intelligent alternative. Letting ACA “fail” as our President advocates, would be even more disastrous. The free market will not necessarily support moral, pro-life values.

I am sympathetic to those who chafe at the idea that Planned Parenthood receives medical reimbursements for non-abortion procedures, when they are the biggest provider and lobbyist for unfettered access to abortion. I would love for Planned Parenthood to go out of business--preferably because abortion is no longer desired by any woman. But I can’t ignore that for many women in rural or low-income situations, Planned Parenthood is their only access to low-cost or no-cost family planning and annual pelvic exams. It is unfortunate that we have let our public health clinics die on the vine from lack of financial support thus enabling Planned Parenthood to fill in the void.

I hope you will consider the lives of the most vulnerable--the unborn--as you proceed to work with your colleagues on health care legislation. Health care is nuanced and complicated. It reaches into our lives in subtle and significant ways. It deserves our best efforts to investigate and address all the angles, not just the fiscal ones.