Abortion and Health Care Reform: How The House Bill Forces Women to Accept Less Coverage Than They Already Have

Last week it seemed that a compromise had been reached between abortion rights supporters and opponents. The compromise was based on the idea that health reform is so important that no one would try to use a single controversial issue as an excuse to bring the whole thing down. So, language was drafted that would sustain the status quo on abortion; no federal funding, but people could still use their own money to buy insurance that would cover them. But just hours before the final vote on the House reform bill, anti-abortion Democrats threatened that unless they got new restrictions on abortion rights they would vote against health reform. Here’s the breakdown:

The compromise: Under the language currently in the Senate Finance Committee’s bill and formerly in the House bill, no federal funding would be used for abortions. Under this provision, called the Capps Amendment, all insurance plans in the exchange would have to keep the money from private premiums and the money from government subsidies separate. Only money from private premiums would be allowed to pay for abortions covered under the plans. This is how current law on abortion works; for example, under Medicaid, federal funds are not allowed to be used for abortions, but some states provide funding by separating their state funds from the federal funds. Republican Senator Collins said that the compromise provision “did a good job of putting up a firewall that would prevent federal funds from being used to finance abortions.” Under the compromise, at least one plan in the exchange would cover abortion services and at least one plan would not cover abortions services, giving every American the option of what type of plan she would like to purchase while ensuring that no federal funding would be used to cover abortions.

The change: The last minute amendment added to the House bill, referred to as the Stupak amendment, goes much further than preventing federal funding from being used for abortions. The House bill that was passed on Saturday “would prevent millions of Americans from buying insurance that covers abortions — even if they use their own money.” Insurance companies are allowed to offer a rider, which is a separate policy that covers only abortion, but this is a hollow promise. We buy insurance because we can be pretty sure that we will need some kind of health services at some point, and there’s a good chance they’ll be out of our financial reach, but if you single out specific services, there’s less chance that we will need that particular service, and buying insurance against the possibility that you will need that single service becomes less logical. For example, if you had to buy a separate insurance policy that covered only broken arms, you probably wouldn’t buy it because you’ll be spending money to cover a specific set of services that you are not likely to need. In the abortion context, an average woman who uses birth control except when she wants to become pregnant will be unlikely to buy an abortion rider, but if she becomes pregnant unexpectedly or suffers complications of an intended pregnancy, she may well end up with an abortion procedure with costs that strain or ruin her financial well being. Even a woman who decides she wants to cover against all risks might not be able to get abortion coverage, because few people would buy it, it is likely that few or no insurance companies will even offer it.

This was not an argument over federal funding; there is agreement from both sides of the aisle that the Capps compromise prohibits federal funding from being used to cover abortions. Instead, the Stupak amendment, now part of the bill that passed the House, deprives women of the ability to choose whether they want to buy insurance that covers abortion with their own premium dollars. This is the only example in the entire health care reform effort of the government trying to force insurance companies to stop covering a service they already cover. As the debate moves into the Senate, we must be clear that we won’t stand for health reform being used as a Trojan horse to sneak in restrictions on women’s ability to choose insurance plans that cover all of our health needs.

EDITORS NOTE: This post, by National Women’s Law Center Vice President for Health and Reproductive Rights Judy Waxman, appeared on the NWLC blog on November 10th. We thought it was important enough to share with you here.

Read more: womens rights

NWLC
by Judy Waxman, Vice President for Health and Reproductive Rights,
National Women's Law Center

Disclaimer: The views expressed above are solely those of the author and may not reflect those of
Care2, Inc., its employees or advertisers.

Carol H.

10:11AM PST on Dec 4, 2009

Like everything I just have one question don't the Senators and Congressman have women in their lives or when they were born they were left on the side of the road.

send a green star

Leia P.

5:45PM PST on Nov 25, 2009

this bill MUST be stopped.

Julia G.

11:01AM PST on Nov 16, 2009

It seems to me that the need for abortion wouldn't exist (except for the mother's health or in the case of rape and incest) if people chose not to be so promiscuous. It's like developing the vaccine Gardisil for young women, when they have a low percentage of contracting disease unless they are having multipartner sexual encounters. So the logic is that we are supposed to pay for other people's indiscriminate behaviors?

erica j.

9:55PM PST on Nov 15, 2009

Lol. I like how some of you think that the money is gonna come out of your paycheck marked "for abortion use" lololol. How much extra do you think you would be taxed to cover abortion? Tax money is all put into one pool of cash. Nothing is earmarked. So, when a woman needs/wants an abortion, the money will be drawn out of that pool, just like if a person has liver cancer from drinking to much, that money too will be drawn out of the pool of money. But guess what, you'll never know the difference!!! The Govt isnt going to let you know how much of your money per month is funding what procedures. Technically, the woman seeking an abortion will be paying for her "own" abortion. If she pays taxes then over time she will cover the cost of her procedure would she not? So, I think everyone needs to just chill out. I dont support the wars, but my tax dollars are still funding it. It is what it is. I personally think that this is all a bunch of crap anyway. This plan is still leaving Insurance companies in charge. We need a single payer health care system. We need the American NHS!!! Not a bunch of insurance big wigs who are still going to be getting rich off our backs. So You all might wanna argue this issue but i think its detracting from the real issue at hand. And that is to insure that any citizen in this country is able to walk into a hospital and receive the services they need, no matter who they are or where they're from.

Elodie W.

10:53PM PST on Nov 14, 2009

Free birth control and comprehensive sexual education would be a great start in the right direction. I do not think that people should use abortions as their main source of birth control. It is dangerous.

I know that if I became pregnant right now, I would abort. I am on birth control, and I cannot support a child, mentally, physically, or emotionally at this point in my life. My partner does not want a child, either, but would never make me get an abortion. He would, however, support my choice, and help me with the procedure, and the after.

I am extremely lucky in this respect.

Halley F.

3:56PM PST on Nov 14, 2009

Medical procedures deemed necessary for the health of the mother to be should be covered regardless. I believe abortions not related to the medical health of the mother should be an out of pocket expense. Birth control should be free to all and sexual education in schools needs to first of all exist and second, need to teach something other than abstinence. We need to start at the root of the problem before tearing each other up over the end result.

Gennai Z.

7:57AM PST on Nov 14, 2009

The choice of a surgical procedure should be left as a private issue between the woman and her physician. NO ONE has the right, morally or otherwise, to dictate that woman's choice of healthcare. This is not an issue of innocence vs guilt, it is an issue of equal choice under the laws of this country. Women are not yet treated as equals here in the USA and to think that negating insurance coverage for abortion is a step in the right direction??? Well, Thank god when I was ill, my private insurance paid for the procedure otherwise I would not have been able to afford the cost financially or otherwise. Abortion procedures should not be used in place of birth control. I have heard of some females having multiple abortions. Bad idea. Very dangerous. Tubal ligation should be done instead. Will this procedure be covered?

Steve R.

8:44PM PST on Nov 13, 2009

I would like to add a couple of points to the discussion.

There are many facets to the issue of abortion. Those that are in favor of abortion should be aware that whatever you believe, from a certain point, the fetus becomes a living being and abortion kills it. I think the term "murder" is a bit harsh, but don't deny this fact unless you want to further alienate the pro-lifers.

If you oppose abortion and advocate certain forms of birth control like the IUD, RU-486 and the morning after pill, you should realize that these forms of birth control do not necessarily stop conception, they always or often abort the fertilized egg. Do not therefore, beat up the pro-choicers because you think they "kill fetuses".

What we should ALL agree on, is that the issue is controversial enough for us all to agree that abortions need to be kept to an absolute MINIMUM through effective education and counselling.

I will be the first one to beat the drum that we have no CLEAR sex education or birth control plicy in this country, and that it is the MAIN cause of many unwanted pregnancies.

Though I am a male, I do believe that boys and men should be held COMPLETELY ACCOUNTABLE for their actions if they "screw around" indiscriminately without taking any responsibility for birth control or the consequences of causing a pregnancy.

In this regard, I believe our country is still very male chauvanist, and EVERYONE, from government to churches, and doctors to parents are to blame.

8:16PM PST on Nov 13, 2009

Abortions are a medical procedure. Whether you like it or not, that is what they are. They are performed BY A DOCTOR in a CLINIC or a HOSPITAL. They are a procedure. One cannot legally perform an abortion unless one is a licensed doctor.

Just because you don't like it, that doesn't make it NOT a medical procedure.

Mary J.

1:26PM PST on Nov 13, 2009

Kim, how much do you think a traumatized 13 year old rape victim will be after she has an abortion? Unfortunately, those decisions aren't always in the hands of the one that is pregnant. What if her parents want to force her to have an abortion and she doesn't believe in it? Or if later on she realizes just what an abortion is?