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D.J. Feldman was 11 weeks pregnant last year when she learned that her child had anencephaly, a fetal defect that left the baby with almost no brain. It is always fatal.

Feldman, a 41-year-old federal lawyer, and her husband had been trying for two years to have a baby. Sadly, her doctor "made it very clear I wasn't to continue this pregnancy," she said.

An abortion was medically necessary. She had little choice.

But after the jolt of the diagnosis and the emotional pain of the procedure, Feldman was in for another shock -- sticker shock. She thought her health insurance policy through the Federal Employees Health Benefits Program (FEHBP) would cover the $9,000 cost of the abortion. It didn't.

 
sweet-a-kins

Asked by sweet-a-kins at 10:42 AM on Dec. 1, 2009 in Politics & Current Events

Level 34 (67,502 Credits)
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Answers (61)
  • I think that the insurance should listen to the Dr.'s diagnosis and projected outcome had she carried to term.

    QuinnMae

    Answer by QuinnMae at 10:47 AM on Dec. 1, 2009

  • For Feldman, unlike many women who have abortion insurance coverage through private-sector employers, abortion coverage provided through her employer -- the U.S. government -- is illegal. The law says that "no funds . . . shall be available to pay for an abortion" under FEHBP. Exceptions are made for pregnancies that are the result of rape or incest, or that endanger the mother's life.

    Feldman's case is instructive. Congress is considering a ban, like the one in federal employee health plans, against federal funding of abortions as part of the effort to reform the nation's porous health insurance system. After hot debate last month, the House approved the Stupak-Pitts amendment, which would prohibit abortion coverage in government-subsidized health insurance, with exceptions for rape, incest and the mother's health.
    sweet-a-kins

    Answer by sweet-a-kins at 10:42 AM on Dec. 1, 2009

  • Feldman's health was in jeopardy. The minority of babies with anencephaly that are carried to term -- dying shortly after birth -- cause complications such as "dysfunctional labor and postpartum hemorrhage, which can increase the risk for the mother," Feldman's doctor wrote in a letter to her insurance company.

    The doctor warned that the complications for a woman of Feldman's maternal age from giving birth to a child with anencephaly "are especially serious . . . and could be life threatening."

    Despite the doctor's plea, the Office of Personnel Management refused to make Blue Cross/Blue Shield pay.
    The fetal anomaly presented no medical danger to you, the mother," OPM wrote to Feldman. "Consequently, we cannot direct the [insurance] Plan to provide benefits for the services in dispute."

    sweet-a-kins

    Answer by sweet-a-kins at 10:43 AM on Dec. 1, 2009

  • Feldman was able to negotiate the fee down from the $8,898 she was billed as an individual, to the $5,000 the Blues would have paid. Federal and insurance company officials do not discuss individual cases.

    For privacy reasons, Feldman, who lives in the D.C. area, doesn't want her full name or agency printed. She has lobbied against the Stupak amendment and the law that places restrictions on the health coverage of federal employees. Those restrictions also apply to others who use federally funded health programs, including poor women on Medicaid, patients in military hospitals and Native Americans who use the Indian Health Service. Federal law even prohibits the D.C government from using its local
    sweet-a-kins

    Answer by sweet-a-kins at 10:43 AM on Dec. 1, 2009

  • That kind of abortion should be covered just like the rape, incest, and mother's life in jeopardy abortions. That poor woman.
    Anonymous

    Answer by Anonymous at 10:46 AM on Dec. 1, 2009

  • she had a choice, the doctor couldn't MAKE her kill the baby, that's just an excuse
    Anonymous

    Answer by Anonymous at 10:47 AM on Dec. 1, 2009

  • why was the procedure $9000 when the average is $372?
    Carpy

    Answer by Carpy at 10:48 AM on Dec. 1, 2009

  • Since when does an abortion cost $9,000? It costs less to have the baby.
    Anonymous

    Answer by Anonymous at 10:48 AM on Dec. 1, 2009

  • A regualr abortion doesn't cost anywhere near that. But those butchers will leave you to bleed to death in their recovery rooms too. This issue should be addressed, but the solution SHOULD NOT open the flood gates to multitudes of "regular abortions" either.
    Anonymous

    Answer by Anonymous at 10:51 AM on Dec. 1, 2009

  • Your story is crap. You don't even offer a link, just lots of cut and paste. This is not the same as a regular abortion and insurance companies don't consider it as such. Women choose to discontinue these types of pregnancies every day without incident, that is why there are tests such as ultrasounds and Amnio's.

    I had a very dear friend go through the same thing. Her ultrasound showed a very deformed child missing almost all of its brain. She had the procedure and it didn't get denied. I know for a fact that she has FEHBP. She is a federal employee and so is her husband. If this was really denied the problem lies with the doctors office for not filing the proper insurance codes/diagnosis.
    yourspecialkid

    Answer by yourspecialkid at 10:57 AM on Dec. 1, 2009

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