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Obamacare Not Responsible for U.S. Abortion Decline

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In November, the Centers for Disease Control and Prevention (CDC) released its Abortion Surveillance report for 2013. It showed that the abortion rate in the U.S. continued its steady decline. In the 46 states reporting data for both 2012 and 2013, the overall number of abortions fell by almost five percent. The decline was widespread, as the number of abortions fell in 41 of the 46 states that reported data for each of these two years. In fact, the U.S. abortion rate has declined consistently since it peaked in 1980 – falling by over 40 percent since that time.

Most of the coverage and analysis of abortion trends tends to produce more heat than light. There is a substantial body of academic research which shows that public funding restrictions, parental involvement laws, and properly designed informed consent laws all reduce abortion rates. Furthermore, good data from the Guttmacher Institute shows that since 1994, a higher percentage of women facing unintended pregnancies are carrying them to term.

However, these facts and figures get relatively little attention from the mainstream media. Instead, many commentators reflexively credit contraception for the U.S. abortion decline. Now it is true that some measures of contraception use have increased. However, the unintended pregnancy rate has remained fairly stable over the years. As such, it is unlikely that contraception use is playing a major role in America’s long term abortion decline.

This year, however, some commentators on the left are putting a different spin on the abortion decline.  They are arguing that the implementation of the Affordable Care Act is responsible for the reduction in the abortion rate. Amy Sullivan, a pro-life leaning Democrat who writes for Yahoo News, tweeted that the Affordable Care Act was “the largest abortion reduction effort in U.S. history.” Similar arguments have been put forth by both Liz Birge writing for dailykos.com and the editorial board of the Portland Press Herald. In her tweets, Sullivan argues that the 2013 abortion decline was due to the fact that the Affordable Care Act increased access to health insurance plans which cover contraception.

That said, there are several flaws with Sullivan’s analysis. First, the timing of the implementation of the Affordable Care Act makes it unlikely it had anything to do with the 2013 abortion decline. Many states did not vote to expand their Medicaid program until midway through 2013 and some of these expansions did not formally take effect until 2014. Additionally, several states have not expanded Medicaid at all.  Furthermore, the Healthcare.gov website where people could purchase health insurance through state based exchanges did not go online until October 2013.

Also, the five percent abortion decline in 2013 was consistent with the abortion decline in previous years. Indeed, according to the CDC, the U.S. abortion rate fell by around 5 percent in both 2011 and 2012. Finally, a number of studies have found that a very small percentage of sexually active women who do not use contraception cite either cost or lack of access as the reason.  Considering that there are already programs in place to subsidize contraception for low income women, it is unlikely that the Affordable Care Act did much to increase contraception use.

That said, the Affordable Care Act, may actually have lowered the abortion rate, but not in the way that Sullivan, Birge, and others think. The unpopularity of the Affordable Care Act led to large Republican gains in many state legislatures in both the 2010 and 2014 election cycles. That has made it easier to enact protective pro-life laws.  For instance, in 2013 Texas enacted legislation which required all doctors who perform abortions to maintain admitting privileges at a nearby hospital and all abortions to be performed in hospital-like surgical facilities. In one year, the number of abortions performed in Texas fell by 14 percent. Unfortunately statistics on the efficacy of pro-life laws receive scant attention from the mainstream media.

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Michael J. New is a Visiting Associate Professor of Economics at Ave Maria University and an Associate Scholar at the Charlotte Lozier Institute.

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