Several states that have banned or restricted abortion since the U.S. Supreme Court overturned Roe v. Wade last year are also ratcheting up government spending to try to help women with challenging pregnancies before and after they give birth.

Increasing funding for pro-life pregnancy-resource centers and extending the time a new mother can stay on Medicaid after delivery are among the measures certain states have enacted in recent months.

“I think pro-lifers realize we’ve done a lot, but it’s not enough,” said Chuck Donovan, executive director of the Charlotte Lozier Institute, a pro-life organization that provides research in science, medicine and statistics, in a telephone interview with the Register. “I just think people are getting more creative under stress, which I think is a good thing.”

Policymakers in pro-life states are acknowledging that with fewer abortions, there are more women who need assistance before, during and after childbirth.

Texas, for instance, had 52,495 abortions in 2021, the last full year abortion was legal in the state, according to the state’s health and human services department; now, all abortions are illegal.

“That’s what Dobbs did. It took abortion off the table and turned the discussion to ‘How can we help women and children?’” said Jennifer Allmon, executive director of the Texas Catholic Conference of Bishops in a telephone interview. “We’re now discussing, ‘How can we help all families?’”

 

Extending Medicaid in Texas

Federal law ordinarily requires that poor women without health insurance qualify for Medicaid for two months after giving birth. During the federal coronavirus emergency, individuals who enrolled in Medicaid were allowed to stay on Medicaid; Congress ended that so-called “continuous enrollment” in Medicaid on March 31, 2023. But the federal American Rescue Plan Act of 2021 also provides incentives to states to permanently extend Medicaid coverage for women to 12 months after giving birth. As of mid-June 2023, 35 states have extended Medicaid postpartum coverage, according to KFF, an organization that tracks health policy.

In Texas, where state law since August 2022 has prohibited abortion except to save the life of the mother, enlarging Medicaid coverage is framed as pro-life.

“I feel like this is a very pro-woman, pro-life statement that we are making, by extending this to 12 months,” state Sen. Lois Kolkhorst, a Republican, said on the floor of the state Senate on May 21. “This is about life, celebrating the miracle that our God and Creator gives us: the ability to procreate and give life to others and making sure that these women have the services needed to stay healthy to take care of those babies.”

Earlier this year, Connie Bunch, mother of a 10-year-old and a 1-year-old, told state legislators in Texas that access to Medicaid because of her most recent pregnancy helped her discover and address serious health conditions she has, including aneurysms, hypertension and diabetes.

“You’re squeamish about going to the ER when you don’t have insurance because it costs an arm and a leg,” Bunch told the Texas House of Representatives’ Select Committee on Health Care Reform on March 16, speaking in favor of lengthening Medicaid coverage. “... And all of that would have been untreated because I don’t go. I don’t go; I don’t have the money. So that’s why I’m for it.”

State officials in Texas project extending Medicaid coverage would serve about 27,000 women per month in the spring of 2024, increasing to more than 120,000 more per month later in the decade. The cost is projected at about $147 million for a two-year period ending in August 2025, according to a fiscal note attached to the bill.

It’s a marrying of Democratic-backed social spending and Republican-backed opposition to abortion, Allmon said.

“Democrats came to me and said, ‘You guys have always been with us on this. Now that abortion is behind us, let’s work together,’” said Allmon, who represents the state’s Catholic bishops. “And I had Republicans saying, ‘You know, we should have been funding some of these things. Let’s do it now.’”

“So we built a package intentionally that will be reflective of Catholic social teaching and a consistent ethic of life, and that won,” Allmon said.

The bill ended up getting overwhelming support from legislators from both parties. Texas Gov. Greg Abbott signed the bill into law on Sunday, June 18. It still needs approval from the federal Centers for Medicare & Medicaid Services, which under the Biden administration has sought to promote access to abortion post-Dobbs.

 

Increased Funding for Adoption and Maternity Homes

The pro-life Lozier Institute has identified increased pro-life social spending this year in other states, including Indiana, Tennessee, Mississippi, Louisiana, Missouri, West Virginia, Kansas, North Dakota, Wyoming, Montana, Utah and Alaska.

Donovan, the organization’s executive director, said the measures provide practical assistance to women in need.

“Our core belief is that women should have confidence that care will be coming their way, that they will not be financially broken by bringing a baby to term,” he told the Register.

Some measures try to make life easier for mothers both before and after giving birth.

A bill enacted May 19 in Texas requires colleges to provide “pregnant and parenting students” with excused absences, the ability to make up assignments, and the ability to watch classes by video — “so pregnant students can finish their degree and not feel like they have to choose between education and parenting,” said John Seago, executive director of Texas Right to Life.

It’s part of what Seago called an effort to “build a pro-life state, not just build an abortion-free state.”

Last month, Republicans in the state Legislature in North Carolina enacted a bill that bans abortions after 12 weeks while also appropriating during the next two fiscal years a total of $1.4 million for maternity homes; more than $20 million to increase state payments for foster care and adoption; and $20 million to provide paid parental leave.

The legislation isn’t completely aligned with Catholic values. The vast majority of abortions will remain legal in the state under the measure, which also appropriates $7 million over the next two fiscal years for nonprofit community health centers to provide contraceptives, an approach the Church teaches is immoral.

But the state’s two Catholic diocesan bishops praised some aspects of the bill (while calling it “not perfect”), saying they “welcome the millions of dollars of funding to support mothers and families.”

“Together these provisions represent progress toward building a culture of life in North Carolina,” said Bishop Peter Jugis of the Diocese of Charlotte and Bishop Luis Zarama of the Diocese of Raleigh in a written statement in May.

On a straight party-line vote, Republicans achieved in each chamber the bare three-fifths majority needed to override the veto of the state’s Democratic governor, Roy Cooper, who vetoed the measure because, he said, “it will make abortion unavailable to many women.”

 

Boosting Pro-Life Pregnancy Centers

The new Texas budget signed in mid-June increases two-year spending on pro-life pregnancy centers, adoption agencies and maternity homes from $100 million currently to $165 million.

In Florida, Gov. Ron DeSantis signed into law a bill in April that bans abortions after six weeks while also appropriating $25 million for pregnancy centers, which free of charge provide products and services such as diapers, wipes, formula, baby strollers and counseling; some centers provide limited medical care  for women with problem pregnancies.

The state currently spends about $4.5 million on such centers, so the new appropriation next fiscal year increases current spending by more than five times that amount.

While the increase is huge, the money is just one aspect, said Rita Gagliano, executive director of Florida Pregnancy Care Network, which administers state funding for pregnancy centers for the Florida Department of Health.

“I would say that the general feeling before Dobbs was that we fly under the radar. Post-Dobbs, there has been a different feel. We do feel more comfortable speaking about the opportunities we provide,” Gagliano said.

Pregnancy-resource centers, as such organizations are also known, can also now provide referrals to doctors for state-funded medical visits for women who aren’t pregnant and aren’t ill.

“What that does is it helps to establish a client in a pro-life medical setting, so if she does find herself with an unanticipated pregnancy, she’s going to keep her baby and not abort,” said Gagliano.

She said more than 100 pregnancy centers in Florida that are part of the state’s network will also be able to provide 24 hours a day, through their websites, an instant connection to a nurse who can chat online by text to pregnant women with questions.

The upshot is an approach that doesn’t just ban abortion, she said, but also helps pregnant women.

“If we’re going to limit abortion, then let’s put our money where our mouth is and help women have their babies,” Gagliano said. “We’re delighted that we have the opportunity to say, ‘Yes, we don’t just care about you not having an abortion, but we do care about the family, about the woman, about the child, and we’re going to help get you through this.’”