The XX Factor

Colorado’s Universal Health Care Proposal Could Ax Abortion Coverage

The state already bans public funding for abortions. Abortion-rights advocates say if single-payer health care passes, there would be no more insurance coverage for the procedure.

Progressives in Colorado are battling over a ballot initiative that would create a single-payer universal health care system in the state. According to some abortion rights advocates, the state-funded program would eliminate insurance coverage for abortion care for the more than 550,000 Colorado women of child-bearing age who can currently get low- or no-cost abortions under their private insurance plans.

Coloradans will vote on the ballot measure, constitutional Amendment 69, this November. If it passes, the state will establish ColoradoCare, a health program that will pay the medical bills of all Colorado residents via a 10 percent payroll tax. Amendment 69 doesn’t explicitly limit abortion; in fact, the problem is that it doesn’t mention it at all. In a June statement, NARAL Pro-Choice Colorado noted that the new amendment would still be subject to an earlier addition to the state constitution that prohibits any state funds from being used for abortion care.

“While we strongly support the goal of improved healthcare for all Coloradans, and many of our members individually support the idea of universal health care,” the NARAL statement reads, “Amendment 69 in not providing guarantees to abortion access means it is not truly universal.”

Passed by a ballot initiative in 1984, Colorado’s ban on public funding for abortion only allows for an exception when carrying a pregnancy to term would directly endanger the life of the pregnant woman. Under Amendment 69, all health care costs in the state would be paid for by ColoradoCare, a subsidiary of the state government, meaning that any woman whose private insurance currently covers abortion services would lose that aspect of her reproductive health coverage unless her life were at risk.

Karen Middleton, executive director of NARAL Pro-Choice Colorado, published a Huffington Post editorial on Wednesday, rebutting accusations that abortion-rights advocates are hindering progress on other women’s health care issues by opposing Amendment 69. “One of the more disturbing arguments we’ve heard is that abortion rights proponents should remain neutral despite these serious policy concerns, and work it out later,” Middleton wrote. “This amounts to nothing more than asking women to ‘wait our turn’ while more important issues are considered. Comparing the relative importance of one health care issue over another is bad policy and bad politics.”

An attorney for ColoradoCareYES, the group that’s fighting to pass Amendment 69, has argued that the new amendment would take precedence over previous ones, effectively supplanting the 1984 public abortion funding ban. “The general rule is that where an apparent conflict exists between two statutes, the courts must attempt to harmonize them to effectuate the intent of the general assembly,” the lawyer wrote in a memo. “If the two cannot be harmonized, the statute enacted last in time controls.”

The two parts of the state constitution would not actually be in conflict, NARAL Pro-Choice Colorado contends, because Amendment 69 doesn’t specifically mention abortion at all. That means the two measures would coexist, ensuring state insurance coverage for all standard medical care besides abortion.

It’s likely that universal health care advocates left out any protections for abortion coverage to ease the initiative’s passage in a somewhat conservative state. Public funding for abortion is rare in the U.S.: The Hyde amendment, a rider that’s been added to every annual congressional appropriations bill since 1976, bans the use of federal Medicaid funds for abortion services except in cases of rape, incest, or to save the life of the pregnant woman. Most states have enacted prohibitions on using state dollars for abortion, too; just 17 use state funds to cover abortion care for women on Medicaid.

But bans on public funding for abortion have gotten more attention in recent months, making them seem like less of a foregone conclusion or a political third rail. This year, for the first time ever, the Democratic Party added repealing the Hyde amendment to its party platform, placing it on a very public chopping block. Hillary Clinton has called it out as a major barrier to women’s rights guaranteed by the Supreme Court. As they push through a “universal” health care plan that could actually strip women of the ability to obtain a common, constitutionally protected medical procedure, Amendment 69’s backers should consider that without affordable access, rights don’t mean a thing.