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The Case for The Equality in Abortion Coverage Act

In 2018, 2,435 Rhode Islanders received an in-state abortion and 382 others came from another state to receive an abortion in Rhode Island. Demand and numbers for abortions in the smallest state of the nation would seem to indicate fair abortion laws; in truth, however, this is not the case. Rhode Island has yet to expand state funded insurance to cover abortion services — a stipulation that prevents over 300,000 residents from having access to abortion coverage —  including 15,000 state employees and their dependants.

In response to these disparaging numbers, the Equality in Abortion Coverage Act (EACA) declares that “ restrictions on abortion coverage have a disproportionate impact on low-income residents, immigrants, people of color, and young people who are already disadvantaged in their access to the resources, information, and services necessary to prevent an unintended pregnancy or to carry a healthy pregnancy to term…The purpose of this legislation is to promote equity in access to reproductive health care.” 

The first part of the EACA calls for the director of the State’s Department of Health and Human Services, Nicole Alexander-Scott, to amend the state’s Title XIX plan to expand Medicaid coverage to pregnant people whose family incomes are between 185 percent and 200 percent of the federal poverty level. Second, the EACA states the director must also set up a “payer of last resort” system to cover prenatal, delivery, and postpartum care for individuals lacking coverage in these areas as well as for people who are ineligible for medical assistance under Title XIX. The next two sections of the bill outline exactly what is covered by the expanded Medicaid program, including pregnancy and birth related medical costs as well as what the bill refers to as “enhanced services,” which include nutrition counseling, high risk care, addiction counseling, and mental health services. Lastly, the EACA ensures that these services be extended up to twenty-four months postpartum.

These provisions to Rhode Island’s current abortion support measures would be extraordinarily helpful to struggling families across the state. The individuals and families who would benefit most from EACA already face a great number of social and economic barriers in their everyday lives their children should not be forced to tackle these same hurdles from the very moment they are conceived. The EACA would remove limits to care and provide all Rhode Island residents with access to abortion, and the help neccessary for recovery. Rhode Island must pass this law and join the 16 states that already provide abortion coverage under their state Medicaid program.  

The Hyde Amendment of 1976 prevents any federal funds from contributing to abortion costs except in cases of rape, incest, if the mother’s life is endangered, or other extreme circumstances. However, this does not mean that government programs are barred from providing abortion coverage. Individual states have the legislative capicity to determine what their Medicaid programs could cover, and many states have since added abortion coverage to their plans. Rhode Island is not one of those states, despite reliably voting democratic and having consistent support for reproductive rights among its constituents. 

Further, because this issue deals specifically with Medicaid, the people who are disproportionately impacted by this lack of abortion coverage are low-income individuals and families in a manner implicative of racial disparity. In its failure to provide abortion coverage to people on Medicaid, the Rhode Island state legislature is perpetuating an incessant and injurious pattern in public health: They are normalizing disparities in healthcare coverage and encouraging its continuation, thereby engendering minority suffering at the hands of the medical community. By passing the EACA, Rhode Island would be taking a step towards providing its residents with a more stable, more equitable healthcare system.

The EACA would take effect immediately upon its passage and, beyond providing abortion coverage, would also provide expansive family planning services that would be of great assistance to any parent, but especially those of low-income families. Beyond covering the costs associated with prenatal care and childbirth, the bill also provides state funding for programs that create better living conditions for the child and improve the parents’ quality of life by way of childbirth classes, addiction counseling, and mental health services. Without the EACA, many individuals will continue to carry unwanted pregnancies which could overwhelm them with financial burden and mental health sacrifice. The EACA would give these individuals a choice about their future. Even if the parents decide to keep their child, it would provide them with a solid foundation to build a proper home. 

The Planned Parenthood Advocates group at Brown was founded in Fall 2020 with the aim of providing support for the Providence Planned Parenthood clinic. Our work would typically involve in-person volunteering, but the remote adjustment has necessitated a different approach. 

Planned Parenthood provides care for many low-income individuals who may not have any form of insurance, making the nonprofit a prime stakeholder in the passage of the EACA. Planned Parenthood treats people of any race, gender, sexual orientation, immigration status, and socioeconomic status, andsupports the EACA not because they are primarily focused on providing abortions, but because they want everybody to have access to safe and affordable family planning services. The EACA l is aligned with their priorities and goals because it  is meant to support the people who are least likely to have access to these types of resources. It is those who have the most to lose if the EACA is not passed that Planned Parenthood supports, those who are suffering right now and being taken advantage of in Rhode Island.

This semester, Planned Parenthood Advocates at Brown has made it our mission to do everything we can to support the passage of the EACA, a bill that has been endorsed by Planned Parenthood of Southern New England since its original iteration in March of last year. We hope to find Brown students and anyone who calls Rhode Island their home who are willing to share their stories and help us to write testimonies that can be presented when this bill reaches the floor of the RI House and Senate. We are also trying to publicize our cause and gain support from a wide range of individuals — starting here with the Brown Political Review. Please reach out to us at plannedparenthoodadvocates@brown.edu if you’d like to get involved.  

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