Pregnancy doctors fleeing Idaho is a crisis. The Legislature has no serious solutions | Opinion

As evidence accumulates, it seems the only thing Idaho’s abortion ban has achieved is to worsen Idaho’s chronic and worsening shortage of physicians. The problem has gotten so bad that Republican lawmakers now at least admit it exists, as the Idaho Statesman’s Sarah Cutler reported.

But the solutions they’re proposing — from counterproductive ones like rolling back an in-state residency program, to simply ineffective ones like making minor changes to Idaho’s total abortion ban — are grossly inadequate to the problem.

House Minority Leader Ilana Rubel, D-Boise, summed up the situation well: “The elephant in the room — the thing that absolutely has to be solved if we are ever going to put any kind of a dent in this deficit — is that we have got to pull back on Idaho’s frankly insane total abortion ban that has no health exception.”

The most serious effort to fix the problem is a bill that would allow frivolous lawsuits filed under one of Idaho’s abortion laws to be dismissed by a judge early in the process. This is an improvement, but one so marginal that its effect will be undetectable.

One obvious solution is to entirely do away with the bounty lawsuit mechanism of enforcement. There’s a key difference between a prosecutor deciding whether to press charges against a doctor based on allegations that they performed an abortion and allowing a private individual to file a lawsuit: profit motive. As long as you have a system where people can make money off of lawsuits alleging abortion, physicians will fear dealing with baseless lawsuits — particularly because, even if you prevail, being sued is punishment in and of itself.

So you can expect that Idaho’s abortion ban will continue driving OB/GYNs out of the state, with lots of serious consequences, including increases in maternal mortality — which the Legislature decided we should stop monitoring last year.

And there will be other consequences. It’s not a far stretch to imagine that the abortion ban has prevented many babies from being born in Idaho.

Talk with women in Idaho who are contemplating whether to try conceiving, and something you’ll hear quite commonly is that they are afraid they won’t be able to receive adequate health care in Idaho. That’s both because of the abortion ban driving OB/GYNs out of the state, meaning it is increasingly difficult to find a doctor for your pregnancy, and because of high-profile cases of women being denied necessary care for complications because doctors weren’t sure whether they would run afoul of the abortion ban.

So getting pregnant in Idaho has become risky. Some women decide to risk it. Tragically, many decide they won’t have kids even though they want them.

And so it isn’t very surprising that the fertility rate in Idaho continues to decline steadily.

The number of births in Idaho per woman aged 15-44 was about 15% higher than the national average in 2013, according to the March of Dimes. By 2023, it had fallen by 14% and was only 5% above the national average (which had also fallen considerably but relatively slower than Idaho’s).

At the same time, there’s very little evidence that abortion bans have reduced the abortion rate. Some lawmakers like to claim that hundreds of abortions in Idaho have been prevented, but surges in abortion rates in surrounding states suggest the procedure has simply been exported to places where it’s legal.

As of last year, evidence had already emerged that the reversal of Roe v. Wade had not led to a reduction in the nationwide number of abortions. Rather, it had been followed by an abrupt reversal of the years-long trend in which the number of abortions had steadily fallen, entering a new phase where the number of abortions is now rising. The latest data review by the Kaiser Family Foundation shows the abortion rate is still rising.

And it’s likely to get worse after this session.

A new law signed by Gov. Brad Little makes sex education opt-in (instead of opt-out, as is currently the case) and allows parents to sue a school district if sex education is provided without written consent. The predictable effects are that participation in sex education will plummet, and many schools will stop offering it. If your goal was to increase the unplanned pregnancy rate, and therefore the abortion rate, this would be one good way to go about it.

If Idaho lawmakers ever get serious about stopping the exodus of doctors — if they ever decide to get serious about reducing the abortion rate, for that matter — they’re going to have to take a long look in the mirror. Tiny tweaks to state law will have tiny results. Serious reform will require facing the fact that they made enormous, consequential errors in the wake of the Dobbs decision.