This story was first published by the Louisiana Illuminator.
Government leaders are split on whether the possibility of an abortion ban in Louisiana should require the state to devote more money to services for pregnant people and vulnerable children.
Gov. John Bel Edwards, an anti-abortion Democrat, said he believes more funding should go toward support services for pregnant people, infants and children if a state abortion law takes effect later this year, though his top health and child welfare advocates haven’t discussed specific proposals yet.
“I do think it’s incumbent on us to do that,” Edwards said last Wednesday. “I think we should do it regardless [of whether an abortion ban takes place].”
Anti-abortion Republican lawmakers who oversee the budget process in the Louisiana Legislature were more circumspect.
Senate Finance Committee Chairman Bodi White, R-Baton Rouge, said he hadn’t considered whether services for women and children should receive more money because of a possible abortion ban, though he is expected to unveil the Senate leadership’s budget proposal Friday.
House Appropriations Chairman Committee Jerome Zeringue, R-Houma, who controls the budget process in the House, said money could be moved around if necessary, after the U.S. Supreme Court decision is finalized that could allow Louisiana’s abortion ban to take effect.
The Legislature’s most powerful lawmaker, Senate President Page Cortez, R-Lafayette, said he wasn’t willing to shift funding into programs for maternal health or children based on a Supreme Court ruling that hasn’t been issued yet.
A draft opinion from Supreme Court Justice Samuel Alito released last week indicates that the court will overturn Roe v. Wade, which requires access to abortion all states. A final decision is expected until June.
“A leaked interoffice memo is not a court decision,” Cortez said.
If Roe falls, Louisiana will immediately prohibit almost all abortion under a state law passed in 2006. It would allow for abortion only in cases where the pregnant patient’s life is at risk or the pregnancy might cause injury to a patient’s life-sustaining organ.
Such a ban would be expected to result in a rise in Louisiana births, though it’s unclear how significant the impact will be.
Louisiana recorded 7,444 abortions in 2021,according to figures the Louisiana Department of Health provided. It includes abortions performed on people from other states. Louisiana’s abortion clinic in Shreveport, for example, saw an influx of Texas residents after abortion restrictions tightened in that state earlier this year.
No state funding in Louisiana goes toward supporting abortions, but several publicly-funded health care and child welfare programs could see an influx in demand if abortion is no longer on the table.
Medicaid likely to grow, foster care uncertain
Assuming an abortion ban results in more pregnant Louisiana residents, it will almost certainly cause the state’s Medicaid budget to rise. The Medicaid program is funded with a combination of state and federal tax dollars and already pays for more than 60% of births in Louisiana.
People who would normally make too much money to qualify for Medicaid can get access to the program when they become pregnant. The income threshold for joining Medicaid for a pregnant person is twice as high as it is for an able-bodied adult – about $4,949 per month for a family of four. Louisiana also automatically pays companies that provide Medicaid health plans thousands of dollars more when one of their existing Medicaid recipients becomes pregnant.
Louisiana also will let pregnant people stay in the Medicaid program for far longer in the next state budget cycle, starting July 1. Currently, people are kicked off Medicaid two months after they deliver, but Louisiana has enrolled in a federal program that will expand that coverage to 12 months.
Medicaid also provides coverage for children in households that make up to $5,897 per month for a family of four. Those families also have access to a food assistance program that helps people who are pregnant and with young children purchase formula and nutritional food. The programs are almost entirely federally funded.
The data is going to say we are going to see more babies, not less. So we have to find a way to add resources.– Rep. Rick Edmonds, R-Baton Rouge
To the extent that an abortion ban means more Louisiana residents are giving birth and taking care of more children, it would likely increase the statewide cost of all of these benefits. Medicaid is an entitlement program, meaning Louisiana has to help the federal government cover the cost regardless of how it impacts the state’s other budget priorities.
What’s less clear is whether an abortion ban will have an impact on the state foster care program.
“It may very well be that we have more kids come into custody,” said Marketa Walters, secretary of the Department of Children and Family Services.
Walters’ agency is already struggling to respond to child welfare calls because of a lack of staff. An abortion ban could result in more activity in Louisiana’s Safe Haven program, for example, which gives new parents the option to leave newborns at designated facilities in lieu of abandonment.
Since Safe Haven was implemented in 2004, 83 infants have been turned over to the government, primarily through hospitals and fire stations. Walters said these babies enter the foster care system, but they are typically easy to place with families.
Women legislators might push for funding
If funding for other types of services materializes, it might be because of a push from women legislators.
While the male lawmakers who oversee the budget process weren’t sure if programs for parents and children should receive a funding boost, several anti-abortion women lawmakers interviewed said an abortion ban would create an urgent need for an expansion of support services for pregnant women and young mothers.
“There’s always been a need for more resources, but [the draft Supreme Court opinion] puts kind of an exclamation point on it,” said Sen. Sharon Hewitt, R-Slidell.
“I think you are going to see more people standing in an urgent manner and in a bipartisan manner to make sure women are taken care of,” said Sen. Katrina Jackson, D-Monroe, who opposes abortion.
Where those resources might go could be controversial though. Hewitt and Sen. Beth Mizell, R-Franklinton, both mentioned providing more funding for the state’s network of anti-abortion crisis pregnancy centers. The facilities say they provide counseling, pregnancy tests and prenatal services while also offering counseling against abortion, but they have been accused of providing false and misleading information.
In the current budget cycle, the state has put $1.26 million worth of federal funding meant to assist low-income families toward anti-abortion pregnancy crisis centers. Women lawmakers and Rep. Rick Edmonds, R-Baton Rouge, are pushing for an additional $1 million for those organizations in the budget year that starts July 1. House Bill 909, sponsored by Edmonds, would support the centers in building a remote, online service network.
“We are certainly going to have to provide women’s health at a higher level,” said Edmonds, who is a Baptist pastor. “There’s no question. The data is going to say we are going to see more babies, not less. So we have to find a way to add resources.”
Lift Louisiana, an abortion rights advocacy organization, has raised concerns that many crisis pregnancy centers in Louisiana receiving funding from the state don’t employ doctors or nurses or offer licensed medical care. The centers are also faith-based and don’t provide birth control to clients.
In some cases, pregnancy centers have falsely claimed that abortion increases a person’s risk for breast cancer and infertility or equated emergency contraception to abortion, according to a report from Lift Louisiana. Lift also says that pregnancy crisis centers have told clients that an abortion administered through medication can be “reversed” – though there is no scientific data to support that theory.
Michelle Erenberg, Lift Louisiana’s executive director, said the centers need to be more closely monitored by the state, especially because they receive federal funding dedicated to helping low-income families.
“I do think there should be some licensing and regulation, and that they should have some medical staff that are licensed and trained,” Erenberg told lawmakers last month.
Legislators have not been willing to take any steps to provide more oversight of the crisis pregnancy centers so far. The Louisiana House on Wednesday rejected legislation from Rep. Aimee Freeman, D-New Orleans, that would have required the state to investigate the center’s operations and use of public money.
Poor health outcomes for Louisiana pregnancies
If an abortion ban results in more pregnancies and births in Louisiana, that increase will be happening in a state that already has one of the worst records on maternal health. Louisiana has one of the highest death rates among pregnant people of anywhere in the country.
Researchers have said the poor track record on pregnancy is, in part, because large swaths of the state lack any access to medical care for pregnancies. Over a third of Louisiana parishes have no OB/GYN, birth center, nurse-midwives or hospital with an obstetric department, according to a 2020 analysis from the March of Dimes.
When people have to travel outside their community to receive basic prenatal care, pregnancies and births become riskier, the organization concluded.