A tale of two mandates

Last week, the Virginia Senate entertained a floor amendment that would require either insurers or the state to pay for the pre-abortion ultrasounds mandated by recently passed legislation. The estimated biennium cost submitted with this amendment totaled $3 million, which, in an overall state budget of $85 billion, barely registers as a drop in the bucket.

Nevertheless, the Senate Republicans clearly showed that this budget debate was not actually about the budget, just as the debate over the ultrasound bill was not actually about women’s health.

Senator Jeff McWaters (R) admitted as much, stating that the budget amendment was “not just simply a matter of an inexpensive test … [t]his is a matter for many of human life, of the sanctity of human life and not about a small, few-million-dollar expenditure for tests that are being discussed on this floor.”

In sum, this legislation was actually all about creating another barrier to abortion services.

Because of the General Assembly’s failure to pass the budget amendment, the mandatory ultrasound law is now officially an unfunded mandate. It requires women to undergo a medical test, regardless of its medical necessity. However, the law does not require insurance companies to cover the costs of the mandatory tests. Furthermore, the law does not require the state to pay for the mandatory tests should a woman lack insurance or the ability to pay.

Of interest, though, is how differently the Governor and Virginia Republicans treat an unfunded mandate in the context of women’s health, as opposed to what they deem to be unfunded mandates in other contexts.

Early in his term, Governor McDonnell created a Task Force for Local Government Mandate Review, to “identify unfunded mandates on both the state and local level as well as examples of federal government overreach that prevent Virginia’s government from focusing on the core functions of government.” In its creation, Governor McDonnell empathized with those localities frustrated by “mandates and red tape.” Delegate Kathy Byron, the original sponsor of the mandatory ultrasound bill, applauded the work of this Task Force, stating, “It is unfortunately rare to see government at any level recognize and take corrective action when it overstretches its regulatory reach.”

The Governor and the Republican majority’s refusal to fund the ultrasound mandate is made even more timely, as both have vilified the Affordable Care Act, the constitutionality of which is currently being considered by the United States Supreme Court.

Governor McDonnell has regularly claimed the individual mandate in that legislation is unconstitutional, an unprecedented expansion of government’s authority into an individual’s healthcare decisions. Specifically, he has posited that “[r]esponsibility is best fostered through individual incentives and not an oppressive federal mandate…Americans should be in control of their health and the decisions regarding their care. Individuals and families, not governments, are best able to decide the right course of action.”

The Governor and Republicans in the General Assembly are quite comfortable protesting against government intrusion, regulation, and mandates when it suits their political agendas. However, the genuineness of these arguments tarnishes when placed in the arena of women’s healthcare, where government intrusion is the exact course of action they have chosen, forcibly separating individuals from their own healthcare decisions.

The full consequences of the legislation that Virginia passed this session have yet to be realized – politically or judicially. However, while that broader future awaits its reckoning, the Republicans today criticize a healthcare mandate from the federal government while simultaneously enacting an unfunded, healthcare mandate from the state government.

And, should the Republicans’ sophist arguments prove successful, one population will suffer greatly – low-income women. Although the mandatory ultrasound law is offensive from its first word to its last, its treatment of women without financial means is particularly cruel and hypocritical. By refusing to fund this mandate, Republican lawmakers are punishing low-income women and those without insurance who seek abortion services.

So, juxtaposing the Republican rhetoric surrounding this ultrasound mandate against the same party’s rhetoric on the Affordable Care Act, I am forced to this conclusion – none of this is about access to healthcare or informing women’s decisions or budgetary constraints or prudent fiscal policies.

It never was.