Obamacare could force taxpayers to pay double for medical abortions
A special report from Operation Rescue
By Cheryl Sullenger, Senior Policy Advisor

There is a disturbing new trend in the abortion industry that could be endangering the lives and health of thousands of women – and costing insurance companies and taxpayers millions.
As the number of abortionists continues to decline, some clinics have found a unique way of staying open using what is known as the “telemed abortion.”
“Telemed” is short for the term telemedicine, whereby medical consults occur with the aid of electronic communications. It is used legitimately in the medical field to lower the cost of consultations with specialist and exchange medical information between physicians electronically. Telemedicine has also been successfully used in legitimate medical practices for such things as history review, psychiatric evaluations, and ophthalmology assessments. However, telemedicine, or care in absentia, was never meant as a replacement for the personal, hands-on examination by a physician.
Now, a Midwestern Planned Parenthood abortion business has taken telemedicine to an all new and dangerous level.
The Telemed Abortion
Operation Rescue investigated telemed abortions in Iowa, which are keeping open a dozen clinics. According to an undercover phone conversation with a receptionist with Planned Parenthood of the Heartland, medical abortions are offered in 16 clinics throughout Iowa, but only four of the clinics actually have doctors. At the other twelve, smaller clinics, telemed abortions have become routine.
A telemed abortion is abortion via a teleconferencing service similar to “Skype.” Patients are put in a room where an off-site abortionist appears on a computer monitor and explains the medical abortion procedure to them over an Internet hook-up. After the brief teleconference, the dangerous abortion drug RU486, also known as Mifepristone and Mifeprex, and its counterpart, Misoprostol, are prescribed. The drugs are then administered to the patient by a nurse or “clinician” who may or may not be licensed. The patient presses a button an on computer screen that opens a box containing the abortion drugs. The patient is never physically examined by the medical doctor prescribing the drugs – or any other, for that matter – and never sees the abortionist again.
Listen to a Planned Parenthood receptionist describe this.

Increased Risks To Women
This development should trouble those who are concerned about the health and safety of women and their pre-born babies.
Mifepristone (Mifeprex or RU 486), the main component of medical abortions, has been responsible for at least eight abortion deaths and over 1,100 serious complications in the United States alone. It is recommended only for early abortions under nine weeks gestation. In addition, medical abortions carry a 7-20 percent failure rate, depending on how the pills are administered. Women who suffer failed or incomplete abortions would require them to be completed surgically or face life-threatening complications. With no doctor in sight, that presents a new danger to women.
Described by one Planned Parenthood receptionist as a “self-induced miscarriage,” the medical abortion process takes days, can be very painful, and involves heavy bleeding and cramping until the pre-born baby is expelled. Yet, the only follow-up offered by Planned Parenthood is a recommended appointment in “two or three weeks” after the abortion where a second ultrasound is offered to make sure the “pregnancy no longer exists.”
This follow-up care is completely inadequate. If tissue from the pregnancy is retained, that presents a risk of infection to the woman that could kill her, especially if care is delayed 2-3 weeks.
In a recently published study conducted on 120 women who underwent medical abortions at 9 weeks, 34 of the women (28%) retained tissue. Fetal heartbeats were detected in fourteen of those pregnancies (11.6%), but abdominal ultrasound only detected the heartbeats in ten of those cases for a 29% failure rate. The study concluded that abdominal ultrasound examination alone is not entirely reliable after medical abortion and also concluded that the higher the woman’s body mass index, the higher the risk of not detecting retained tissue or even a complete pregnancy.
“I cannot imagine a woman going through the process of miscarriage, either natural or forced, and not having access to a physician, especially for follow-up care,” said Newman. “Any number of things could go wrong, and to never actually be seen by a licensed doctor during the entire process seems risky at best, grossly negligent, and perhaps criminal.”
Illegal Abortions?
An abortion is legally defined in Iowa Code 146.1 as, “the termination of a human pregnancy with the intent other than to produce a live birth or to remove a dead fetus.” It is a legal requirement that abortions in Iowa only be done by “licensed physicians.”
In an undercover call made by an Operation Rescue investigator, the Planned Parenthood receptionist was clear that the so-called “nurse” would actually be doing the abortion procedure.
Listen to the audio clip.

Caller: Okay, so when she goes in for the procedure, um, do you guys like have a doctor there or something, that she can talk to?
Planned Parenthood: Some of our sites are called telemed, which there is not a doctor on site. All instructions would be given through teleconferencing and there’s a nurse there to answer any questions. Some of our bigger clinics, yes, we have a doctor on site.
Caller: Okay, so if she has questions she has a nurse she can talk to. Would it be the nurse who actually administers – who actually gives her, like, the procedure or whatever?
Planned Parenthood: Right.
Caller: Okay.

According to this information, it is doubtful that these abortions are even legal since the abortions are not done by a licensed physician, but an abortion worker at a clinic that the physician never visits.
“The term ‘nurse’ is used loosely by abortion clinics. More often than not, what they refer to as a ‘nurse’ is really an unlicensed worker with little education or training,” said Newman. “It is actually very rare to find an abortion clinic that employs registered nurses or even licensed practical nurses, because they drive up the costs and drive down the profit margin.”
This means that dangerous medical abortions are being done on unsuspecting women without the direct supervision of a physician – and perhaps without the oversight of any licensed medical personnel whatsoever. The patient is never physically examined by the abortionist, whose only contact with her is a brief teleconference. After the teleconference is terminated, she never sees the abortionist again.
Susan Haskell, a Planned Parenthood abortionist in Des Moines, is involved in the teleconferencing prior to abortions around the state. According to a receptionist at a Planned Parenthood in Council Bluffs, Haskell never comes to their clinic, and neither does any other licensed physician. And so it is at the other eleven telemed abortion clinics run by Planned Parenthood: no physician — ever.
“Taking an abortion pill is not like taking an aspirin. Women have died from it,” said Newman. “Yet Planned Parenthood has reduced the dispensing of this dangerous abortion drug to little more than supplying advice of the kind you might get from a pharmacist when buying an over-the-counter medication. That is placing the lives of women at serious risk.”
Operation Rescue attempted to contact the Iowa Board of Medicine for a comment on the legality and safety of telemed abortions, but numerous phone calls were not returned.
Women Unaware Of Dangers
Are women even aware of the new risks involved? Probably not. The receptionist from Planned Parenthood that spoke with our undercover investigator seemed surprised that questions about emergency protocols were even asked. Below is a partial transcript of that conversation.
Listen to the audio clip.

Caller: Is the ultrasound person, like, a doctor? Are there any doctors there at all in case anything goes wrong?
Planned Parenthood: There’s nurses there. Nurses, mp’s and doctor – er, sorry, clinicians. There wouldn’t be anything to go wrong in the medical procedure because you don’t do anything with that right away. You get one pill there in the clinic and that pill stops the pregnancy from growing. Then they give you four more pills, and those pills they send you home with, and they’ll give you the instructions on how and when you would take those.

Nothing to go wrong? Certainly not until the patient is long gone from their facility and on her own to deal with the painful and risky abortion. What a woman would do in the event of an emergency remains unclear.
Bilking Insurance Companies and Taxpayers
But beyond the obvious health concerns to women and their pre-born babies, telemed abortions in Iowa are costing insurance companies millions of dollars in inflated charges. Soon, it could be taxpayers footing the bill.
According to Operation Rescue’s research, which surveyed medical abortions from coast to coast, the average cost of a medical abortion nationally is about $390, ranging from a low of $300 to a high of $600. But in Iowa, insurance companies are being billed at a rate of $1,000, two and a half times greater than the national average – with a fraction of the cost.
However, if the patient does not have insurance, the cost of the medical abortion is “discounted” by Planned Parenthood to $500, still well above the national average. Limited financial assistance from various abortion funds can further discount the abortion, but the money from the grant money still goes into Planned Parenthood coffers insuring that the abortion clinic never receives less than $500 for each telemed abortion.
Listen to a Planned Parenthood receptionist explain this.

“Planned Parenthood of the Heartland is making a killing on medical abortions,” said Newman. “Think about it. They are charging by far the highest price in the nation, but at perhaps the lowest overhead costs. They don’t have the expense of having to pay for a doctor on site or pay for traveling expenses. The abortionist never leaves Des Moines. That’s how they can afford to keep abortion clinics running in small towns such as Spencer, Storm Lake, and Ankeny.
“Overbilling has the result of driving up the cost of health insurance for everybody. And if taxpayers are forced to fund abortions, there’s no telling how much they will charge, because government funding is a blank check. This will mean that we all will be paying more for health coverage in order to cover the exaggerated rates for these abortions. Meanwhile, Planned Parenthood laughs all the way to the bank.”
In fact, less than a week after the House passed the health care bill, an amendment was rejected that would have prevented tax funding of medical abortions. That means that whenever a person subscribes to an insurance plan in the government exchange, tax dollars will pay for their medical abortions, and in Iowa, it will be at over twice the price of other states.
So profitable is the telemed abortion that there is concern that Planned Parenthood of the Heartland, which operates the clinics in Iowa, may try to sell their system to abortion franchises in other states. That will mean an increase in abortion profits for Planned Parenthood at a burdensome cost to insurance companies and taxpayers, all at the consequence of an increased risk of life-threatening complications to women.
Telemed Abortions Symptomatic Of Widespread Problem of Abortion Industry Abuses
The dangerous and costly telemed abortion is just another example of abortion industry abuse and exploitation that has become so widespread in the United States that anyone is hard pressed to find an abortion business that is in full compliance with the law. The entire industry is rife with problems, as evidence by recent headlines, including sex abuse and non-reporting, filthy and unsafe clinic conditions, unlicensed workers, substandard care, illegal abortions, fraud, and illegal disposal of human remains and medical records, to name a few.
The solution that will protect women, babies, and society from further harm by the greatest moral problem of our time is complete abolition of abortion and the restoration of legal personhood to the pre-born.
Until that can be accomplished, there are steps that can be taken to protect women and their babies from the immediate threat of risky telemed abortions. As the new health care system is about to be implemented, which will flush millions of dollars into the abortion industry, now is the time for states to step up and protect women by outlawing abortions in absentia. Efforts should also be made to prohibit the bilking of insurance companies and taxpayers with over-inflated fees that Planned Parenthood is now charging for the low-cost telemed abortions in Iowa, lest their dangerous scheme to give medical abortions via the Internet spread to other states.