By Erica Terrini and Jillian Quattlebaum
Capital News Service
RICHMOND — It will be harder to get an abortion in Virginia because of two laws passed by the 2011 General Assembly.
Under House Bill 2434, abortions will not be covered by certain private insurance plans in Virginia. On April 6, the General Assembly upheld Gov. Bob McDonnell’s amendments to bar insurers from covering abortions if they participate in Virginia’s health benefits exchange program.
In addition, the assembly passed Senate Bill 924, which will classify clinics that perform at least five first-trimester abortions per month as hospitals. This law, which will take effect July 1, will require such clinics to meet stricter standards governing physical facilities, equipment and staffing.
Seventeen of Virginia’s 21 clinics that provide first-trimester abortions might close because of the expense of meeting the hospital standards.
Abortion rights advocates say both bills will greatly restrict access to abortions. However, the bills’ supporters say the laws will help protect women’s health.
HB 2434: Virginia’s Healthcare Exchange Act
This was an innocuous bill during the regular legislative session: It simply designated a process for creating a health benefits exchange — a way of getting insurance — when the federal Affordable Care Act takes effect in 2014. In February, HB 2434 easily cleared the House and Senate.
But then McDonnell amended the bill to prohibit private insurers that participate in the exchange program from covering abortions.
The Republican governor’s amendments stated “that no qualified health insurance plan that is sold or offered for sale through an exchange established or operating in the commonwealth shall provide coverage for abortions, regardless of whether such coverage is provided through the plan or is offered as a separate optional rider thereto.”
The amendments allowed abortion coverage only “when the life of the mother is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself, or when the pregnancy is the result of an alleged act of rape or incest.”
The General Assembly took up the amendments on April 6 during its “reconvened session,” when legislators review gubernatorial vetoes and recommendations.
The Republican-controlled House of Delegates voted 59-36 in favor of McDonnell’s amendments banning abortion coverage.
The Senate, where Democrats hold a slight majority, deadlocked 20-20 on the issue. But Republican Lt. Gov. Bill Bolling, the chamber’s presiding officer, broke the tie by voting for the restrictions on abortion coverage.
Lawmakers upheld McDonnell’s amendments despite protests from Delegate Charniele Herring, D-Alexandria, and abortion rights advocacy groups. Before the reconvened session, they held a press conference to protest the governor’s attempt to prohibit abortion coverage.
“This is an assault on women’s health, and a play for political points,” Herring said. “The Virginia exchange is supposed to make health care more accessible, not less. This is an undue burden placed on women.”
At the press conference, Herring was joined by Virginia representatives of the NARAL Pro-Choice America, Planned Parenthood, the American Civil Liberties Union and the National Organization for Women.
Jessica Honke, director of public policy for Planned Parenthood Advocates of Virginia, called McDonnell’s amendment “the greatest government intrusion to women’s health care.”
“Private insurance companies should not be told what they cannot cover, and this is health insurance that women currently have that will be taken away from them,” Honke said.
But the governor’s supporters cited a precedent for his amendments: The federal law already prohibits tax dollars from funding abortions except in the case of rape or incest or if the woman’s life is at risk. McDonnell’s recommendations merely apply such restrictions to private insurance offered through the Virginia health exchange.
SB 924: Regulating Clinics as Hospitals
Under this law, clinics that perform at least five first-trimester abortions per month must meet hospital standards governing “construction, maintenance, operation, staffing, equipping, staff qualifications and training.”
Virginia will be the only state where a patient would have to go to a hospital to receive a first-trimester abortion.
Like Virginia’s Healthcare Exchange Act, SB 924 wasn’t controversial at first.
The original draft of the bill, introduced by Sen. Ryan McDougle, R-Mechanicsville, simply required the Virginia Board of Health to promulgate and enforce standards to ensure “infection prevention, disaster preparedness, and facility security of hospitals, nursing homes, and certified nursing facilities.” It did not mention abortion clinics. On Feb. 2, the Senate unanimously approved the measure.
But three weeks later, the House added an amendment to SB 924 by Delegate Kathy Byron, R-Lynchburg. It required the Board of Health to apply those same standards “to any facility in which five or more first-trimester abortions per month are performed.”
Byron said she offered her amendment because it would protect women’s health. She said her amendment was unrelated to the “pro-life vs. pro-choice” debate over abortion rights.
Byron said that the House has consistently passed bills to require abortion clinics to meet hospital standards – and that the Senate Education and Health Committee has consistently killed those bills, preventing a “fair vote” by the full Senate.
By amending the already-passed Senate bill, Byron could circumvent the Senate committee and get a vote by the entire Senate.
On Feb. 21, the House voted 63-34 to add Byron’s amendment to SB 924. Delegates then passed the overall bill, 67-32.
On Feb. 24, the Senate took up the House-amended bill. What happened foreshadowed what would transpire in April on McDonnell’s recommendation to ban abortion coverage in Virginia’s Healthcare Exchange Act.
A motion to approve Byron’s amendments tied, 20-20, after Democratic Sens. Phillip Puckett of Tazewell and Charles Colgan of Manassas joined the 18 Republicans in voting for the bill.
Bolling then broke the tie and voted in favor of SB 924. It then went to McDonnell, who signed it into law.
The governor called the measure a “clinic safety issue.” Byron said she does not believe the bill will “hinder access for women to be able to have abortions.”
Abortion rights advocates disagree.
Sen. George Barker, D-Fairfax, said SB 924 would result in the closure of about 80 percent of Virginia’s clinics that offer abortion services. It has the potential to hinder health care access for women, he said.
Barker said the law does not differentiate between medical abortions (in which drugs are used to terminate a pregnancy) and surgical abortions (in which special instruments are used to empty the uterus).
As a result, Barker said, the law would impose hospital standards on a doctor’s office that provides the medication to induce an abortion.
He said SB 924 would apply overly strict stands to clinics that offer first-trimester abortions. He said there is no need for such clinics to meet the physical construction standards for hospitals.
The legislation is “not something done for the safety of the patient,” Barker said. “Because if it were a patient safety issue, you would do it for everything that involves similar procedures” – such as cosmetic surgery.
By the Numbers
Here are statistics on pregnancies and abortions in Virginia for 2009, the most recent year for which data are available.
For all pregnancies:
Live births: 104,979 (76 percent)
Induced terminations: 26,356 (19 percent)
Natural fetus deaths: 6,585 (5 percent)
For teenage pregnancies only:
Live births: 8,284 (67 percent)
Induced terminations: 3,568 (29 percent)
Natural fetus deaths: 431 (4 percent)
Source: Virginia Department of Health
Abortion Rates by Locality
The reporters then compiled a spreadsheet showing what percentage of pregnancies in each city and county in 2009 ended in abortion.
In four localities (Falls Church, Williamsburg, Emporia and Manassas), there were more abortions than births in 2009 — meaning more than half of the pregnancies were terminated.
In 16 localities (mostly in the western part of the state), less than 5 percent of the pregnancies were terminated. Scott County, for example, had 224 births and four abortions; the city of Norton had 62 births and one abortion.
Here is an interactive map that allows you to explore the data: