Biden’s Abortion Offer for Vets Falls Flat as GOP Aims to End It

President Biden‘s move to allow Department of Veterans Affairs facilities to provide abortions in limited circumstances is barely expanding access to the procedure nationwide, even as conservatives seek to block the option in court and Congress.

The VA provided just 34 abortions from September, when the agency released the new policy, through February, according to a VA letter to members of Congress that was obtained by Bloomberg Government. That’s far below the department’s estimate that it would provide or pay for 1,000 in the policy’s first year.

The slow traction of the VA’s new policy demonstrates how few tools Biden has to significantly broaden access to abortion over the opposition of Congress and federal judges. Separately, the Senate is scheduled to vote Wednesday on whether to block the VA policy.

Few pregnant veterans even qualify to receive an abortion at the agency’s medical centers because the VA’s conditions to receive one are so strict. And even if they do meet the criteria, patients may not turn to VA health providers to terminate a pregnancy because they don’t know it’s available or decide to go elsewhere, say veterans, former VA staff, and national abortion advocates.

“Thirty-four abortions being performed in the VA is not going to have a material impact on the thousands of women who do not have access any more to abortion or reproductive services generally,” said Delphine O’Rourke, a partner at Goodwin Procter LLP who specializes in women’s health “There’s policy, there’s politics, and what is really being done on the ground.”

Sen. Tommy Tuberville (R-Ala.), with the support of Sen. Joe Manchin (D-W. Va.), is leading the Senate effort to end the VA policy. The legislation needs only a simple majority of senators voting to pass but it’s still unlikely to become law because it lacks enough support to override a presidential veto.

“We’re just trying to get them to go by the rule of law,” Tuberville said. “It’s not about abortion. The VAs aren’t set up for abortions. They’re going to have to spend a lot of money to be able to do it.”

VA Press Secretary Terrence Hayes declined to confirm how many patients have received an abortion. Every VA facility has been ready since Sept. 9 to “provide or authorize abortion care to eligible veterans and VA beneficiaries,” he said in a statement. The VA estimated the policy would cost the agency $2.1 million in the first year, according to an August memo from Dr. Shereef Elnahal, undersecretary of veterans affairs for health.

Introducing Abortion Services

Veterans and some of their direct family members can get abortions at a VA facility if carrying the pregnancy to term threatens their life or health, under the policy. They are also eligible if the pregnancy is the result of rape or incest, matching what military hospitals provide. The criteria is the same regardless of state laws because VA staff work for the federal government, according to a Justice Department memo.

“We came to this decision after listening to VA health care providers and veterans across the country, who informed us that state abortion restrictions are creating a medical emergency for the veterans we serve,” VA Secretary Denis McDonough wrote in a separate letter to agency staff.

Staff in emergency care, primary care, mental health, and pharmacy have or will receive training on the VA’s new abortion policy, Hayes said.

Women’s Care

The agency only in recent years began providing health care tailored to women, such as prosthetics sized to fit female legs. Just 44% of female veterans are enrolled in the agency’s healthcare, according to the VA.

Despite the expanded offerings, female veterans sometimes seek gender-specific services, such as mammograms, outside the VA, said Ginger Miller, a Navy veteran and president of the Women Veterans Interactive Foundation.

As for maternity care, the agency doesn’t provide full obstetrics care on site. Pregnant patients typically see outside doctors for labor and delivery, with the VA covering the cost.

“The VA is there to provide services to all veterans,” Miller said. “But the VA also has its limits.”

Getting the word out about benefits for women veterans can be a challenge, particularly for those who dealt with sexual harassment at VA in the past. Kayla Williams, former director of the Center for Women Veterans, spent hours thinking of ways to reach new parents about the VA’s breastfeeding benefits, including pumps and lactation counseling, she said.

“It’s really hard to find every single woman veteran out there and make sure she knows about the full suite of benefits available,” Williams said. “It can be especially hard when trying to communicate with women who had a negative experience in the military.”

Efforts to Overturn

In Carter v. McDonough, a Christian nurse practitioner is asking a court to block the VA’s abortion policy.

Stephanie Carter, the VA employee suing the agency, argues that being asked to administer abortions in cases other than to protect the life of the pregnant patient violates her “sincerely held religious beliefs,” according to her original complaint.

The VA told her she isn’t required to perform abortions and offered to transfer her to another position, according to a court filing. Carter argued that working in a medical center that provides abortions in cases of rape or incest would violate her beliefs.

The case is in the Western District of Texas before Judge Alan Albright, nominated to the bench by President Donald Trump. Carter is backed by the same attorneys that represented a football coach before the Supreme Court after he was fired for praying on the field.

A coalition of 18 mostly GOP-led states filed a brief supporting Carter. Alabama Attorney General Steve Marshall, one of the two state attorneys general leading the group, declined through a spokeswoman to provide evidence that people living in his state are receiving abortions at VA facilities under the new policy.