'Patient safety decision': Veterans Affairs changes ruling to allow for abortions in certain cases
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While the Department of Defense will provide leave and cover travel costs for servicemembers traveling out of state for an abortion, the Department of Veterans Affairs is offering the procedure for the first time.
The moves follow the Supreme Court’s June ruling to overturn Roe v. Wade and allow individual states to decide whether abortion would remain legal in their jurisdiction.
Since the Supreme Court decision, at least 14 states have prohibited or restricted abortion care.
Secretary of Defense Lloyd Austin signed a memo this month stating that the Supreme Court ruling has impacted service members’ access to reproductive health care, along with recruiting and retention.
Since the Supreme Court decision, Austin said in the Oct. 20 memo, Pentagon officials have heard from service members and their families who have concerns about the uncertainty of accessing reproductive and abortion services.
Service members and their families may be forced to travel greater distances, take more time off from work and pay more out-of-pocket expenses to receive reproductive health care, Austin said.
“In my judgment, such effects qualify as unusual, extraordinary, hardship, or emergency circumstances for service members and their dependents and will interfere with our ability to recruit, retain, and maintain the readiness of a highly qualified force,” he said.
Austin’s directive establishes travel and transportation allowances for service members and their dependents if a reproductive health care service like abortion is not available in their local permanent duty station area.
TRICARE, the military’s medical insurance, has covered abortions if the pregnancy was a result of rape or incest, or a doctor certifies that the mother’s life would be endangered if the fetus was carried to term, according to TRICARE’s website.
More:Pentagon report: Military has performed 91 abortions at its facilities since 2016
VA pushes for change
Last month the VA updated its rule in the federal register to have a policy similar to TRICARE.
Like TRICARE, the VA is providing abortions for veterans and Civilian Health and Medical Program of the Department of Veterans Affairs beneficiaries in cases of rape, incest or the mother’s life is at risk because of the pregnancy, according to the VA’s Sept. 9 interim rule.
“VA is acting to help to ensure that, irrespective of what laws or policies states may impose, veterans who receive the care set forth in the medical benefits package will be able to obtain abortions, if determined needed by a health care professional, when the life or the health of the pregnant veteran would be endangered if the pregnancy were carried to term or the pregnancy is the result of an act of rape or incest,” the VA’s interim rule states.
According to the VA's website, the agency is “taking steps to guarantee veterans and other VA beneficiaries have access to abortion-related care anywhere in the country.”
“This is a patient safety decision,” VA Secretary Denis McDonough said in a Sept. 2 news release.“Pregnant veterans and VA beneficiaries deserve to have access to world-class reproductive care when they need it most. That’s what our nation owes them, and that’s what we at VA will deliver.”
Dr. Shereef Elnahal, health undersecretary for the Veterans Health Administration, testified before Congress on Sept. 15 and told members that “restricting access to abortion care has well-documented adverse health consequences, including increased risk of loss of future fertility, significant morbidity or death.”
“This patient expansion is a patient safety decision first and foremost to ensure enrolled veterans and VA beneficiaries can access life-saving reproductive healthcare services at VA no matter where they live,” Elnahal said.
Elnahal said if authorized under the VA’s Veteran Community Care Program, the VA will pay for abortion counseling from providers in the community and for qualifying abortions from community providers.
Today I’m testifying about VA’s decision to provide pregnant Veterans with access to abortion counseling and—in certain cases—abortions. Bottom line: this was a patient safety decision that will save Veterans' lives, and there’s nothing more important than that. pic.twitter.com/6pOgwWbwRU
— VHA Under Secretary Dr. Shereef M. Elnahal (@USHVHA) September 15, 2022
He estimated that the VA would conduct 1,000 abortions annually.
During a Sept. 21 hearing for the Veterans Affairs Committee, McDonough confirmed that at least one of the VA’s medical centers conducted an abortion since the interim ruling.
More:'You can't just get up and leave': The outsized impact of abortion rights rollback on the military
What opponents and proponents say
The VA change has been championed by Democrats in Congress and opposed by Republicans.
During the Sept. 15 House Veterans Affairs Committee hearing, Rep. Mike Boost, an Illinois Republican, argued that the interim ruling violates the Veterans Healthcare Act of 1992, which prohibited the VA from providing abortions as medical care.
Other Republicans including Sen. James Lankford of Oklahoma, have cited the same statute.
The Ethics & Religious Liberty Commission of the Southern Baptist Convention and the United States Conference of Catholic Bishops also wrote letters this month opposing the VA’s change.
“The ERLC is gravely concerned about this IFR as the United States government should never force taxpayers to fund abortions nor force healthcare professionals to violate their dearly held beliefs about the value of every human life,” the Ethics & Religious Liberty Commission wrote.
Democrats have cited the Veterans Health Care Eligibility Reform Act of 1996 to say that that act allows the VA to provide “needed” hospital care or medical services.
The American Academy of Family Physicians, American College of Obstetricians and Gynecologists American College of Physicians also submitted an Oct. 10 letter that supports the VA’s decision.
“Like all medical matters, decisions regarding reproductive health care, including abortion care, should be made by patients in consultation with their clinicians and without undue interference by outside parties,” the medical organizations wrote.
Nonprofit and nonpartisan veteran organization Vet Voice Foundation wrote in an Oct. 10 letter that it supported the VA’s decision and said that in the wake of the Supreme Court’s June decision, the VA secretary would be abandoning his duties of providing needed medical care if there wasn’t a change.
Vet Voice Foundation said they think the VA’s interim rule should expand to authorization of abortion care in all cases instead of just cases of rape, incest or medically determined by a doctor.
Justice Department and North Carolina Attorney General weigh in
The Department of Justice issued a Sept. 21 opinion that allows the VA to perform abortions without criminal penalization to VA employees who provide the service.
“The Supremacy Clause of the U.S. Constitution bars state officials from penalizing VA employees for performing their federal functions,” the Department of Justice ruling stated.
More:When will NC’s ban on abortions after 20 weeks take effect? Legal experts disagree
In an Oct. 10 letter with 23 other attorneys general, North Carolina Attorney General Josh Stein said he supported the VA’s interim rule.
“It is wrong to ask our servicemembers to risk their lives for us, yet fail to give them the health care they need,” Stein said, commending the VA for its steps to provide abortion in certain cases.
Stein said because North Carolina is one of the few states in the South where a lawful abortion can be accessed, expanding protections for veterans will “help reduce the strain” on the health care system.
Staff writer Rachael Riley can be reached at rriley@fayobserver.com or 910-486-3528.
This article originally appeared on The Fayetteville Observer: Why the Veterans Affairs is pushing to allow abortions in some cases
