Two-tier health care in a post-Roe US


When the US Supreme Court overturned the Roe v. Wade precedent, we knew that it would result in the red states proceeding to ban abortion in almost all instances, even in cases of rape or incest or when the life of the mother is in danger from the pregnancy. What may not have been anticipated is how wide ranging the ripple effects might be. We seem to be moving into a situation where we have two health care systems, one for the blue states and one for the red states, where the red states do not just not have access to abortion but also lose other services as well as lose people who can afford to move to other states.

Idaho is a good example of what is happening where small towns in red states are in danger of losing all obstetrics and gynecological services since physicians are worried that by providing medical care for problematic pregnancies, they may be laying themselves open to criminal prosecutions.

Across Idaho, doctors are leaving, looking for states where politics don’t dictate how they practice medicine. The consequences of Idaho’s anti-choice laws hit Sandpoint fast and hard, hollowing out medical care for women within months. For years, the town had a maternity ward that delivered as many as 350 babies every year – now it has nothing. The OB-GYN ward shut down this spring and doctors have been fleeing the state in a steady stream, seeking shelter in places where their work doesn’t put them at risk of criminal charges or big lawsuits.

For people like Sanders, pregnancy care in town is no longer an option. This is what happens when a state government that’s been itching to ban abortion enacts some of the most restrictive laws in the country and ensnares all of reproductive health and a good share of routine medical care in its dragnet. But the women of Sandpoint are clear about one thing they want others to know: this can happen anywhere in the post-Roe United States. Nowhere is as safe as you might believe and the battle won’t stop at state borders.

Idaho is one of several states that had trigger laws: immediate abortion restrictions that went into effect when Roe v Wade fell a year ago. In August of 2022, the state enacted a near-total ban on abortion with exceptions only if the mother’s life is in danger, or in the case of rape and incest. Those instances require a police report to be filed. The state also adopted what it called an “abortion trafficking” ban, which bars taking minors to other states for abortion care. Family members can sue doctors for thousands of dollars if they perform an abortion, and doctors may face criminal fines and even prison time.

Idaho also became the only state in the country to stop tracking maternal mortality rates. Activists say it’s like they don’t want anyone to know how deadly their decisions might be.

The fear beset doctors and is pushing them out.

Dr Amelia Huntsberger moved to Sandpoint 11 years ago with her husband, planning to put down roots, build a medical practice and stay through retirement. She’s an OB-GYN, her husband an emergency room doctor. They both grew up in smaller cities in the north-western United States, so Sandpoint was a natural fit.

This July, the Huntsbergers’ home on a winding road on the edge of town was filled with moving boxes.

By the end of summer, they will be gone, starting over in Oregon, starting over with new jobs and new schools for their three kids, practicing medicine in a state that doesn’t leave them vulnerable to arrest or lawsuits for saving their patients’ lives. This is not what they wanted or planned, but as Huntsberger explains through intermittent tears across her patio table, leaving Idaho became their only way forward.

“Yeah, this is a conservative state. We knew that when we moved here. But it’s become very extreme. We now have some of the most extreme examples of government interference in healthcare that exists across the country,” says Huntsberger. “And there’s that irony – we are a liberty state: ‘You do you. I’ll do what I do.’ Except if you have a uterus and it’s something related to healthcare, then the government suddenly has a lot to say, without bothering to understand what they’re legislating. There’s some real willful ignorance here.”

It has seemed, she says, like a willful act on the part of lawmakers to fail to understand the repercussions on the laws they have enacted. The impact that falls most heavily on women and families, and particularly on those who don’t have a lot of money or power.

It is indeed a tragic irony that those who shout most loudly about keeping government out of the lives of people are the most enthusiastic about government intrusion when it comes to women’s health.

This is the way things are shaking out in the post-Roe world.

Comments

  1. SailorStar says

    I disagree about Idaho being a “liberty state” or having gotten worse over time. I was at Mountain Home (Navy base) in the 1970s, and it was pretty horrible then. The base was okay, but step off the base (for example, to go shopping or hiking or fishing or camping) and you were surrounded by 12-year-old sister-wives with their babies on their hips, anti-government types demanding their welfare and food stamps and housing stipends from the gov’t., “disappeared” Mormons, and hyper-aggressive and hyper-armed northern hillbillies. You had to be very, very careful going hiking or camping because of all the pot farms and the armed idiots guarding them. I understand since then, meth has become a fun and exciting hobby, and there are meth labs everywhere.

    Wasn’t it in an Idaho Walmart where a woman was shot by her toddler who was playing in her purse while she was shopping? Practically everyone is armed and on a hair-trigger.

  2. says

    It is indeed a tragic irony that those who shout most loudly about keeping government out of the lives of people are the most enthusiastic about government intrusion when it comes to women’s health.

    For libertarians, abortion, birth-control and women’s health and rights have NEVER been “individual liberty” issues — they’ve always been “states’ rights” issues: keeping the US government from “interfering” in matters where states (and of course businesses and churches) had some unspecified divine right to dictate and control individuals’ private lives. For them, any meaningful action by the US Government to enforce US Constitutional rights on US soil is, and always has been, seen as “tyrannical overreach.”

  3. Jazzlet says

    where the red states do not just not have access to abortion but also lose other services as well as lose people who can afford to move to other states.

    Mano I think you missed a “not” out of this sentence (last in the first paragraph) where I have put one in bold.

    [I have corrected it. Thanks! -- Mano]

  4. birgerjohansson says

    “*What may not have been anticipated*” is a phrase that can be used about most far-right initiatives, both in the US and Britain.

    Unintended consequences spreading and trashing society, while barely sapient demagogues congratulate themselves. The last six-seven years have been awful.

  5. sonofrojblake says

    I’m confused. What makes anyone think this wasn’t anticipated, or intended? I’d have thought it was part of the point, to get rid of those troublesome doctors who have wild ideas like women gaming rights and stuff. Don’t want that sort round here.

  6. jrkrideau says

    We need all kinds of medical staff here. Maybe the Canadian Gov’t should do a bit of advertising about fast-track immigration procedures in JAMA or the New England Journal of Medicine.

  7. John Morales says

    Maybe the Canadian Gov’t should do a bit of advertising about fast-track immigration procedures in JAMA or the New England Journal of Medicine.

    Most developed economies already do that stuff. Brain drain.
    Not great for the country that losing much of its most promising young talent, of course… but hey, Canada needs them more than they do, or something.

    (We in Australia do too, of course)

  8. sonofrojblake says

    The UK NHS is catastrophically short of nursing staff and doctors. Perhaps they’d like to a take a 70% pay cut and come and be overworked here? No?

  9. John Morales says

    Couldn’t without a lot of hoops anyway. Brexit means the UK is no longer part of the Schengen area. No more of this free movement of labour, none of this common market stuff for you lot.

    (Fewer farm workers, etc.)

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