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Romneycare Had Little Impact on Massachusetts Abortion Trends



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Last month, an article by Brian Fung on the Atlantic Monthly website sent the media spin machine into overdrive. It provided data from the Massachusetts Department of Health which showed that abortion per capita in Massachusetts decreased after Romneycare took effect in 2007. A number of media outlets including Slate and Commonweal have eagerly made the case that universal health care is an effective strategy for reducing the abortion rate. Furthermore, the Massachusetts abortion decline has become a favorite talking point for Catholic University of America Professor Stephen Schneck and other self-described pro-lifers who are supporting President Obama.

However, a closer look at the data provided by the Massachusetts Department of Health provides good evidence that the abortion decline in Massachusetts post-Romneycare is statistically consistent with the decline that has been taking place since the early 1990s. I obtained annual abortion data from the Massachusetts Department of Health and replicated Fung’s findings. Then for every year from 1990 to 2011, I calculated the Massachusetts abortion rate per thousand women of childbearing age. This is generally thought to be a better measure of the incidence of abortion than the per capita measure which Fung used.

The results were clear. Between 1991 and 2006 — before Romneycare took effect — the average annual percentage decline in the Massachusetts abortion rate was 2.52 percent. Between 2007 and 2011 the average annual decline was 2.54 percent. In short, the difference in the Massachusetts abortion decline pre- and post-Romneycare was miniscule. Overall, it seems clear that the abortion rate in Massachusetts continued on a very similar downward trajectory after Romneycare took effect in 2007.

Another factoid that has received attention from Fung and others is the sharp decline in the abortion rate for minors in Massachusetts. Here it does appear that the minor abortion rate started to decline more quickly after 2007. Still, these statistics should be interpreted carefully. The abortion data for minors reported by the Massachusetts Department of Health shows a considerable amount of variation from year to year. For instance, in 2001 the number of abortions performed on minors fell by over 21 percent. In 2003, the same figures indicate that minor abortions increased by 18 percent. With statistics this volatile, any fluctuation needs to be interpreted with caution.#more#

To his credit, Fung does express some caution about his findings. He acknowledges the downward trend in the Massachusetts abortion rate since the early 1990s. Still, Fung quotes two academics to bolster his argument that Romneycare reduced abortion rates. Unfortunately their comments are unpersuasive. Danielle Bessett, a sociologist at the University of Cincinnati, does not cite any studies, but anecdotally reports that some low-income Massachusetts residents are “delighted” they have better access to contraception. Harvard rheumatologist Patrick Whelan axiomatically assumes better access to contraception will reduce abortion rates — even though research by both the Guttmacher Institute and the U.S. Centers for Disease Control find that a very small percentage of sexually active women forgo contraception because of cost or lack of availability.

Overall, there is no peer-reviewed research showing that greater health-care coverage reduces the abortion rate. Furthermore, the experience of states that have offered more generous provision of public-health benefits is instructive. For instance, in 1974, Hawaii passed legislation requiring all employers to provide relatively generous health-care benefits to any employee who works 20 hours a week or more. Since that time, Hawaii has consistently had one of the lowest rates of uninsured adults in the country. However, according to data from the Guttmacher Institute, Hawaii’s abortion rate consistently exceeds the national average.

An even better example comes from Tennessee. In 1994, Tennessee launched an ambitious public-insurance program to cover its uninsured. TennCare, as it is called, expanded Medicaid to cover people who couldn’t afford insurance or who had been denied coverage by an insurance company. With an initial budget of $2.6 billion, TennCare quickly extended coverage to an additional 500,000 people by making access to its plans easy and affordable. The program, however, became so expensive that Tennessee was forced to scale it back in 2005.

Despite the fact that Tennessee invested heavily in more generous public-health benefits, its abortion rate has not changed much since the mid-1990s. In fact, the decline in Tennessee’s abortion rate is actually well below the national average. Between 1995 and 2005, the Guttmacher Institute reports that the national abortion rate fell by 13.8 percent. However, in Tennessee the abortion rate fell by only 3.3 percent. Overall, it seems clear that more generous health benefits in Tennessee did little to reduce the incidence of abortion.

Every election cycle media outlets are quick to promote any research — even superficial research — that purportedly shows that welfare programs or public-health programs lower the abortion rate. Unfortunately, the substantial body of peer-reviewed studies documenting the effectiveness of pro-life laws, including parental-involvement laws and public-funding restrictions, is all but ignored.

It is disappointing that many media outlets are more interested in providing political cover for Democrats than offering a serious and balanced analysis of abortion trends in the United States.



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