Abortion and the House Health Care Bill
The health care bill narrowly passed by the House this weekend has raised the ire of liberal Democrats who view concessions on abortion funding included in the Stupak-Pitts amendment as an attack on women. Congresswoman Nita Lowey said the amendment “puts new restrictions on women’s access to abortion coverage in the private health insurance market even when they would pay premiums with their own money.” Her comments echo the position of NOW. I took a look at the Stupak-Pitts amendment (it’s just 3 short pages here) and it seems to me the case has been overstated (surprise!) and conclusions have been drawn that are not yet in evidence. But there are certainly problems and inconsistencies in the amendment that I’d like to see addressed by the Senate or in reconciliation if the core of this amendment is to remain.
In general, under the bill, government money cannot be used to pay for abortions. The public option will not cover abortions with the accepted exclusions of rape, incest, or danger to the mother. If you get your health insurance through the government or with government subsidies your plan will not cover abortion though you will have the option to purchase a rider with your own money. The amendment does not apply to insurance purchased privately with personal money including insurance offered through employers who cover abortions or offer riders in their plans.
That leaves people who will buy insurance through the newly created, government-administered, insurance exchange. This will largely serve people who are currently uninsured, the self-employed, people who buy their own insurance, and some small businesses. It is intended to provide affordable insurance to the uninsured and underinsured, and reduce premiums to the privately insured by effectively putting them in a big pool that offers them the group rates enjoyed by employer-sponsored plans. Specifically:
1) a private individual buying insurance on the exchange with personal money will be able to buy a policy with abortion coverage assuming the private insurers are offering it; and
2) low income individuals who receive a government subsidy to help them afford health care insurance cannot buy a policy on the exchange that offers abortion coverage. They may be able to use their own money to purchase an insurance rider covering abortion assuming insurers make it available.
The two places where I used the word “assuming” are a major hitch in the language of the amendment and are areas of major concern to the pro-choice movement (actually, they find the entire amendment objectionable but I think these are the places where they find the greatest imminent risk of backsliding). The amendment requires any insurer who participates in the exchange with a plan that offers abortion coverage to also offer a “plan that is identical in every respect except that it does not cover abortions.” There is considerable concern that insurers will choose to avoid the expense and controversy and simply not offer plans that cover abortion.
Further, the history of state Medicaid plans with abortion riders also offers concern that insurers simply will not choose to provide that coverage either. If either or both of those decisions occur then a considerable segment of the female population will in fact be unable to purchase abortion coverage and this would be a considerable reversal of current policy. It’s just conjecture now but state history suggests the result is a real possibility.
But there’s big lie taking place here — the distinction between private purchasers and subsidized purchasers is just an illusion. Let’s say Mr. Rich buys his own insurance on the exchange from Blue Cross Blue Shield of Oklahoma and it includes abortion coverage. Now let’s say Mr. Poor, who receives a government subsidy to purchase insurance, also buys his coverage from BCBS of OK but he is required to buy the plan without abortion coverage. Why does that make pro-lifers feel better? Does anybody think that somehow BCBS is keeping those premiums separate, that the profit the company reports at the end of the year will distinguish between those plans, or that when they are forced to meet claims under abortion coverage that they are tapping a segregated pool of money? Of course not! It’s a pure fiction. In fact, even if insurers in the exchange choose not to offer abortion coverage many of those same companies do offer it under employer-sponsored plans. It’s a nonsensical distinction!
So what’s the point of demanding that companies offer policies without abortion if they offer coverage with it? I see three things: first, pro-lifers want to be certain they will have insurance options that don’t include abortion coverage – fair enough. Second, notice the requirement doesn’t work the other way around – a company that offers a policy without abortion is not required to offer one with it. This makes sense because it would otherwise shut out companies with a general policy of not providing that coverage. But, more importantly, it leaves open the possibility of having no company offer abortion coverage at all. Third, pro-lifers see this as another step toward reducing abortion availability and will, in the future, argue the fiction I noted above and demand all insurers in the “government-administered” exchange eliminate abortion coverage.
That third point is really what this is about. The yelling and screaming about no public money for abortions or abortion coverage simply results in using accounting tricks and creative bookkeeping to satisfy pro-life demands. If you think this bill actually results in absolutely no public funding going toward abortions or abortion coverage you are just fooling yourself. It’s taking from one pocket and putting into the other pocket. We give money to Israel each year for defense with strict conditions that none of that money will go to building settlements. But defense is Israel’s top priority. If we didn’t give them enough defense funds they would find it elsewhere and have less money to spend on settlements. So no matter how you view it we are helping to fund settlements. Same thing here. What’s important is what comes next and that is why the pro-choicers are really up in arms. It’s all about the slippery slope and this amendment is extremely slippery.
Therefore, I’d like to see two changes:1) any company that offers abortion coverage outside of the exchange is required to offer a plan within the exchange that covers abortion; 2) any company that offers abortion coverage in the exchange is required to offer an affordable abortion rider to individuals receiving government subsidies to be purchased with their own money (another fiction). This guarantees the availability of abortion coverage without changing the core of the amendment.
The big tent party is really being tested on this abortion issue, as it should be. This is one thing which has very little middle ground and both sides are set in their positions. There will be no Henry Clay to step forward on this one, John C,Calhoun or Daniel Webster will care the day .
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I find ironic that the body in which the Stupak amendment is being offered, and specifically the GOP folks who are pushing it, has a health plan that would cover an abortion. Apparently, it is only if “the life of the mother is at stake”, but something that the Senate is unwilling to extend to the commoners. It also appears that the GOP has had the opportunity to opt out of this coverage and have chosen not to.
I guess, after all, the GOP (at least the Senate) is pro-choice after all, as long as the choice is theirs.
http://www.politico.com/news/stories/1109/29456.html
Laurie, If I’m remembering correctly, the Republicans have offered many amendments that would require the Congress to accept the public option that we will be forced on the rest of us. All have been voted down by the majority.
I think the issue here, and I wrote about it at my place, is this:
1. The left will never leave the pro-abortion crowd & the feminists under the bus. They are simply too large, well funded, and vocal to be dis-empowered.
2. Since the public option is designed to lead to a single payer system, and will eventually manage ALL health care, the Stupak Amendment would basically mean an abortion ban. Again, the left isn’t going to bury the pro-abortion crowd forever.
3. Pelosi and her cabal were going to offer the blue dogs the sun, the moon, and the stars to get this passed. They needed a win, and temporarily enraging the pro-abortion crowd was a small price to pay. If they have to ignore this compromise in the future to satisfy one of their major constituent groups…well, you know. Now that they have the bill passed, they’ll likely not honor all of the compromises.
4. Considering the reach and importance of this bill, where are the protests from the feminists and other pro-abortion groups? If this were a Republican sponsored bill, there would be mass protests! Or, do they already know that they’re going to be cared for in the near future?
If the Senate manages to pass something, it will go to committee to consolidate the two bills into something that both houses can vote on. Guess who gets to pick who is on that committee? It will be at that phase that the Democrats will alter the bill to their liking.
Matt,
Just curious: Are you concerned at all that the GOP Senate is supporting an amendment that clearly does not reflect their chosen options?
The pro-choice and feminist groups were all over the media yesterday swinging against Stupak, just not convered in the conservative media, as Mikke points out. Right or wrong, we expect them to do this as preserving abortion rights sits atop of their platform. For some of them, abortion rights is the whole ball of wax. They have been entirely consistent.
I will turn your quesiton around. If this were the DNC displaying blatant hipocrisy, would not FOX news, Glenn Beck et al be all over it? And shouldn’t the pro-lifers be out in force on this one? Where is the conservative outrage over the apparent chasm of difference between the GOP Senate’s own government-provided health options- which they have chosen to preserve even when offered the opportunity to opt out- and those that they loudly seek to deny the public? Could it be that the conservative media and the politicians themselves have chosen to look away from this issue because it doesn’t support their agenda of bashing the Democrats?
The conservative media-and their politicians-will tell you everything they want you to hear. But is it all you need to know? In this case, I don’t think so.
Fairness update:
If you go to the original link I provided, you will see that the RNC has opted out of the abortion coverage.
I still ask the question: Why did it take 19 years and outside media pressure for the GOP to come to this conclusion?
Good question, and, in all honesty, and I don’t know. However, it is a good sign that they have recognized and acted on the issue. Sometimes public scrutiny has that effect.
I am aware that there has been a lot of noise from the pro abortion crowd. But this amendment threatens to end abortion. I’d think there’s be people taking to the streets for this, or is talking to the media all that they will do? Or, as I have suggested, will they just make some statements to the press, as they know that Pelosi is going to take care of them when the time comes?
Please do not assume that I only use FOX as a source of news. I frequent many mainstream websites, CNN, MSNBC, USA Today, ABC, and sometimes even the Huffington Post or the Daily KOS. It is helpful to see all the sides of an issue, as well as what the official statements of the administration are.
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Matt,
The RNC and Senate didn’t “recognize” the issue just yesterday. Their current policy has been in place since 1991 and they were presented with the option to opt out of abortion coverage in the years since. Plain and simple, they were “busted” by the media outlet. But yes, they did respond swiftly.
Why aren’t the abortion rights activists out in the streets? Maybe they will be, who knows? Perhaps it’s because they are very savvy political organizations who know hoe to effectively get things done throught the system. Maybe you’re right and they’re sure Pelosi will protect them.
Or maybe-just maybe- it’s because they aren’t led by the greatest community organizers of our time-Beck, Hannity and Michele Bachman.
@ Laurie
They must be good, they didn’t even have to pay the protesters to show up!
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You have laid our your argument for changing the abortion amendment very well, Mike. I really believe this entire piece of legislation is guilty of applying creative accounting techniques to make it appear different than it really is. What I wouldn’t give for some straight talk from both sides of the aisle?
The abortion issue is indeed, a very slippery slope, with neither side willing to compromise much at all. I tend to agree with Matt however, when he says the bill will be altered to the liking of the pro-choice crowd. They are entirely too well funded and vocal for the Democrats to be able to ignore, if they were even inclined to do that in the first place.
I agree that Pelosi did what was necessary to secure a win here but my point is that the amendment is not so bad for the pro=choice group (I hate the term “pro-abortion” — even pro-choicers are not “pro” abortion — a dreadful concept) if it will include the changes I suggest. And if that’s enugh to put the abortion issue of this reform to bed then they should do it and move on to the really important parts of this that desperately need fixing. By the way Matt, the pro-choicers have been all over this issue — it’s just not covered by Fox News — they decide, then report….or not.