The Abortion Compromise in the Senate Health Care Bill

As you have probably read by now, the Senate introduced its version of the health care bill yesterday. As expected, it’s good and bad — it includes a public option, but leaves a lot of people out in the cold, and opens up the healthcare debate to an other four years (at least) of what FDL aptly calls “partisan football” (and I would recommend reading their take on the bill — it’s the most comprehensive and critical I’ve seen). 31 million more people, though, would gain health care coverage, and there would be expansions of Medicaid and CHIP.

The good news out of the Senate bill is that it ditches the Stupak amendment language and goes back to a compromise based on the Hyde amendment. Of course, women’s rights advocates can only be so happy with Hyde-based language, since Hyde is a horrible amendment, but the chances of overturning it within the context of health care reform are slim to none; the best we can do is maintain the status quo, get health care reform passed, and then dig in on Hyde (something that reproductive justice groups like SisterSong have been doing for years, without the full, necessary support of mainstream women’s rights organizations).

Harry Reid’s health care bill goes back to the Capps compromise in the House — it basically says that federal dollars won’t be spent on abortion, but at least one plan within the federal health insurance exchange has to cover it. In other words, it keeps the current law.

This is crucial if pro-choicers want to see any sort of victory in the final bill. Assuming this version of the bill passes — and that’s a big assumption with anti-choice democrats in the Senate — the abortion language will have to be hashed out in conference committee. That’s the only way that the Stupak amendment is going to be removed. If anti-choice Dems push for similar language in the Senate bill, we’re pretty much sunk.

Stupak has been framed by the mainstream media as only cutting off abortion coverage to some women — generally code for low-income women who don’t have private health insurance. In fact, low-income women who rely on programs like Medicaid for their health care already don’t have access to abortion, and haven’t in several decades thanks to the Hyde Amendment (some state programs, however, will cover abortion care). What the Stupak amendment does is block funds not only from federally-funded health care programs, but from private programs as well. While it doesn’t outlaw private insurance companies from covering abortion, it does block them from offering abortion coverage to people participating in the health care exchange; those numbers are expected to be fairly large, creating an incentive for companies to cut abortion coverage over time. Or, as Bryan Beutler puts it in summarizing a new study by the George Washington University School of Public Health and Health Services, “though the immediate impact of the Stupak amendment will be limited to the millions of women initially insured through a new insurance exchange, over time, as the exchanges grow, the insurance industry will scale down their abortion coverage options until they offer none at all.” He continues:

Furthermore the study finds that the supposed fallback option for impacted women–a “rider” policy that provides supplemental coverage for abortions only–may not even be allowed under the terms of the law. “In our view, the terms and impact of the Amendment will work to defeat the development of a supplemental coverage market for medically indicated abortions. In any supplemental coverage arrangement, it is essential that the supplemental coverage be administered in conjunction with basic coverage. This intertwined administration approach is barred under Stupak/Pitts because of the prohibition against financial comingling.”

The authors also note that though the direct impact of the Stupak amendment on women who receive insurance from their employers will be initially minimal, the provision’s tentacles could nonetheless reach into the employer-provided insurance market, too, “further driv[ing] the industry to shift away from current abortion coverage norms and toward product designs that meet exchange and Hyde Amendment requirements.”

Nothing but a lot of bad.

Time to start putting pressure on your senators.

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6 comments for “The Abortion Compromise in the Senate Health Care Bill

  1. SunlessNick
    November 19, 2009 at 1:09 pm

    Does anyone know of a petition that can be signed by people outside the US?

  2. November 19, 2009 at 3:06 pm

    The thing that gets me about the whole “abortion rider” proviso –

    Pro-lifers have long decried the hypothetical woman who uses abortion as birth control. Such a setup enables those women and only those women (assuming any actually exist) to get abortions.

  3. November 19, 2009 at 8:20 pm

    The provider clause is in the bill.

    PROVIDER CONSCIENCE PROTECTIONS.—No individual health care provider or health care facility may be discriminated against because of a willingness or an unwillingness, if doing so is contrary to the religious or moral beliefs of the provider or facility, to provide, pay for, provide coverage of, or refer for abortions.

    I would love to see this shit stripped from the final language.

  4. Evrybdy44
    November 20, 2009 at 8:17 pm

    The idea that a govt provided or assisted healthcare option could have a choice on the funding of a completely LEGAL procedure is mind boggling!

  5. SunlessNick
    November 21, 2009 at 11:54 am

    In answer to the question I asked, Planned Parenthood sent me this:

    It let me sign it from the UK, so other non-US users should be able to do so too.

  6. southern students for choice-athens
    November 22, 2009 at 4:24 pm

    SunlessNick, it would be good if you could also encourage letter-writing among your fellow citizens in the English-language media in your country, both on the internet and off, that is read by Americans, both tourists and expatriates. The latter are especially worth targeting, as they are people who have established some sort of residency in a different country from that which they hold citizenship, in this case America, but they can (and often do, with motivation) vote absentee and otherwise participate politically in their country of citizenship while residing in another country.

    Expatriates are often well-educated (or still in college, a lot of expatriates are college students) or professionals who are working in a different country, maybe for a short period of time. There’s a long history of this especially in some professions, like medicine, for example, which has the term for expatriate doctors who either are highly specialized or who are doing some sort of humanitarian/charity work.

    You can google “locum tenens” for more information about this, and add your country to get more information about that. If they tend to concentrate in one area (probably a big city) that might be an especially good city to get letters to the editor on these issues.

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