ACA Myth: Sterilizing Minors in Oregon

LizBRPolitics12 Comments

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Earlier this week, I came across an article that seemed so outrageous that I couldn’t believe that people were actually trusting its veracity. The claim of the article, which has been reported only on blogs and news sites to the right of Fox news, is that due to the horribleness of the Affordable Care Act, minors in Oregon as young as fifteen can get sterilized for free against their parents’ wishes.

Let me say that again: people believe that one of the drawbacks to Obamacare is that fifteen-year-olds in Oregon are going to start getting free hysterectomies and vasectomies without telling their parents.

Since the very beginning of Obama’s administration, his critics have taken proposed portions of health care reform, bastardized them, and started a damaging rumor. Sarah Palin’s rants against death panels, for example, were linked back to the end-of-life planning that the Affordable Care Act made available to people who agreed to participate in fully voluntary counseling from health care professionals. Knowing that, I wondered what the truth was that had been manipulated and strangled to the point that people could actually believe that Obama wants to secretly sterilize children. (Anyway, wouldn’t that damage the right-wing claim that he is the most “pro-abortion” president in history? Seems like a conflict of interest to prevent pregnancies if you like abortion so much.)

Let’s start from the beginning.

The Affordable Care Act’s contraception mandate requires insurance companies to cover contraception with zero copay. There are discussions to be had about the Constitutionality of this mandate, but those can be held elsewhere, like on your political rival’s Facebook page. The important thing to the discussion of sterilization is that if you have insurance in the United States, your insurance company must provide you with zero-copay contraception. According to the Wikipedia page for the mandate, the list of covered contraceptives includes anything that is FDA approved. So: male and female condoms, hormonal/oral birth control, IUDs, implants, patches, spermicide, diaphragms, etc.

It also includes sterilization. Interestingly, sterilization is not contradictory to the religious beliefs of many who oppose birth control, although it is still prohibited by the Catholic church.

The basic reasons for sterilization and contraception to be covered without a copay is that they are categorized as preventative drugs. If you have insurance, you may have noticed that after the ACA initially passed, insurers began providing preventative drugs and services without charging co-pays.  The widely accepted theory is that by providing preventative services for free, our national health improves and our overall costs go down.

What does this have to do with minors in Oregon?

The state flag of Oregon

In Oregon, minors as young as fifteen can give informed consent for many medical procedures, which means that they are allowed to make decisions without their parents’ approval. According to Oregon’s Public Health website, minors can consent to things like: treatment of sexually transmitted infections, dental procedures, and treatment for mental health or emotional disorders. Oh, yeah, and sterilization.

Before you start listening to people talking about how fifteen-year-olds aren’t emotionally developed enough to make a lifelong decision like getting surgically sterilized, tell them this: Oregon does not allow minors to flippantly walk into a doctor’s office on summer break, request a sterilization, and then get operated on without ever telling their parents. The statutes that govern a minor’s ability to give informed consent for a sterilization are incredibly strict and nearly impossible to accomplish.

In 2011, the following guidelines were in place for a minor who wants to be sterilized:

  • prove that the procedure is in their “best interest.”
  • exhaust every possible method of treatment other than sterilization first.
  • be fully capable of giving informed consent, which includes knowing all of the associated risks and side effects of sterilization.
  • find a doctor who will consent to doing a surgery, which can’t create a threat to the patient’s life or health.
  • GO TO COURT to get a judge to approve the procedure.

The only difference that the Affordable Care Act could make in regards to these statutes is that now there is no determination of who would pay for the procedure, because the insurance company will do that. (If, of course, the minor has insurance.) Versions of these statutes have been passed and repealed every two years since the 1950s, and they will be revisited again 2013. The statutes also include rules like “no hysterectomies” and lists of admissible and inadmissible evidence for the court proceedings.

Why does Oregon have these statutes? Because, according to the statutes, “The Legislative Assembly finds and declares that sterilization procedures are highly intrusive, generally irreversible and represent potentially permanent and highly significant consequences for individuals incapable of giving informed consent. The Legislative Assembly recognizes that certain legal safeguards are required to prevent indiscriminate and unnecessary sterilization of such individuals, and to assure equal access to desired medical procedures for these Oregon citizens.”

In other words, Oregon lawmakers aren’t out there championing the right of teenagers to get their tubes tied. They do, however, recognize that there are situations where a minor might be in need of a medical procedure that their parents are not willing to approve, and if so, that teenager has the right to petition the court for approval. The only example I could think of that could meet all of these standards would be if a minor with a physical disability or illness was informed by his or her doctor that sterilization could lead to an increased quality of life. If that minor wanted to have the procedure done and understood the risks, but was not given parental permission, then he or she could get a lawyer, go to court, and try to convince a judge that their lives would be greatly improved by the procedure.

With apologies to the fear-mongers who are trying to convince people that Obama wants to sterilize the youth of American FOR FREE and WITHOUT PARENTAL PERMISSION, the scenario in which a young person with a disability can petition the court to undergo a medical procedure just isn’t scary. To make the claim that the Affordable Care Act is somehow encouraging children to make lifelong decisions about their fertility without parental guidance is irresponsible and unethical. It’s like a friend of mine said when she read the original article’s headline: “There really ought to be rules about who can use the word ‘news’ in their URL.” If your claim is so outrageous that not even Fox News or Glenn Beck will pick it up, and it can be debunked by sleuthing for public documents for all of fifteen minutes, maybe you shouldn’t try to pretend it’s factual.

 

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LizBRACA Myth: Sterilizing Minors in Oregon

12 Comments on “ACA Myth: Sterilizing Minors in Oregon”

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  1. Avatar of Juniper
    Juniper

     

    (Anyway, wouldn’t that damage the right-wing claim that he is the most “pro-abortion” president in history? Seems like a conflict of interest to prevent pregnancies if you like abortion so much.)

    Is it perhaps the idea that sterilisation could potentially be perceived as the “ultimate” abortion? In that it perhaps also plays into the idea of potential life going beyond fertilised, so that by sterilisation, all potential for life is removed? I don’t know.

    Other than that – very interesting article!

     

    1. Avatar of [M] QoB
      [M] QoB

      That’s the Catholic position (of the Church, not most practising Catholics I know): it’s one of the reasons behind the prevalence of symphysiotomies in Ireland instead of c-sections (which you couldn’t do too many of and allowed for tubal ligation at the same time) in decades past.

      1. Avatar of Juniper
        Juniper

        On the one hand, I’m glad to be informed, on the other, I rather wish I hadn’t look up symphysiotomy on Wikipedia. Thank you, though. Seriously.  And it’s very much interesting to see what the Church’s position is.

        1. Avatar of LizBR
          LizBR

          Oh, I read about that “procedure” in an Obstetrics textbook from 1902 that I picked up at a yard sale. It was one of the more horrifying procedures listed. *shudder*

  2. Avatar of Brenda
    Brenda

    What I find most  hilarious/nauseating/infuriating about this is finding a doctor who will sterilize an adult woman under the age of 35 is damn near impossible. What the hell makes these ignorant fools think a doctor will gladly agree to do it for a teenager?

    1. Avatar of LizBR
      LizBR

      The first time I saw this article posted, that’s immediately what I thought of.  With how hard it is for grown women to have control of their own bodies in this way by finding a doctor to sterilize them (or even just give them an IUD!), how on earth is a teenager going to find someone to do it? It’s completely unrealistic.

  3. Avatar of Susan
    Susan

    What is so frustrating about this is that there are people who believe, really believe, that ACA=ApoCAlypse, and will believe crap like this without giving it a second thought, then regurgitate it as “proof”.  Arglebargle.

  4. Avatar of mxandb
    mxandb

    Wow, as an Oregonian, I really need to read the news more often. I had not heard about this “news.”

    But I do know that every child who does not have insurance (say, through their parents’ plans) can Get coverage through the state. http://www.oregonhealthykids.gov/ (the handy link with cost info: http://www.oregonhealthykids.gov/families/cost.html )

    I think it helps to consider the state’s history on medical policies too. We have the Death with Dignity Act that allows for doctor-assisted suicide and we have a medical marijuana program. We also have a doctor for a governor (this is his third term, non-consecutive). I’m not an expert in this by any means but when it comes to medical needs, we’re pretty open (in the polls, not like as individuals, I’m not speaking for whack-a-dos and morons, just from a perspective).

    Anyway, Oregon is awesome. I love it. Thanks. :)

    1. Avatar of sequined
      sequined

      There’s also an anti-pregnancy program called C-Care (https://public.health.oregon.gov/HealthyPeopleFamilies/ReproductiveSexualHealth/OregonContraceptiveCare/Pages/index.aspx) that gives you free contraceptive care in Oregon, including IUDs and stuff. I used it at age 25, but I think it’s more aimed at teens/college students? Not totally sure, but the website seems aimed at teens.

      Aaaannnnddd… that’s only half of Oregon’s state flag. It’s double sided! It’s the best one there is!

      1. Avatar of mxandb
        mxandb

        Thankfully, I’ve never had to use that coverage but it’s great to know it’s there!

        It’s always hard to tell people they forgot the beaver. :) For some reason, they always start giggling…

         

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