Myths About Abortion Coverage Offer 'Disservice' To Health Reform Debate, Opinion Piece Says

Main Category: Abortion
Also Included In: Health Insurance / Medical Insurance
Article Date: 10 Sep 2009 - 6:00 PDT

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The "inflammatory statements" about coverage for abortion services in congressional health care reform proposals "do a disservice to a complex issue of public policy: how, in the context of health reform, to balance the deeply felt views of both sides in the abortion debate," columnist Ruth Marcus writes in the Washington Post. Although Marcus writes that she is "firmly in the camp of those who think the abortion decision should be left up to the woman," she adds she is "sensitive to concerns" by those opposed to abortion "that their tax dollars not be used to pay for the procedure."

However, "[t]ax dollars are already used to pay for abortions," Marcus writes, adding that "even the Hyde Amendment, which since 1976 has prohibited the use of federal Medicaid funds for abortions," permits the use of Medicaid dollars for the procedure in cases of rape, incest or when the woman's life is in danger. She adds, "Americans who believe that abortion should not be permitted, even in such cases, are nonetheless required to pay, yes, tax dollars to underwrite these procedures." In addition, tax credits offered by the federal government to purchase health insurance and subsidized coverage for those who lose employer coverage do not exclude plans that cover abortions. Also, most private insurance plans offer abortion coverage, making the issue "unavoidabl[e]" in the discussion of health reform, Marcus writes.

According to Marcus, the "controversy has two dimensions:" if abortion services should be covered in a public plan if it is created, and if private plans offered through health insurance exchanges that receive federal premium assistance subsidies should be allowed or required to cover abortion services. While the Senate version of the health reform bill "so far is silent on the subject," a House Energy and Commerce Committee amendment "nicely threads these narrow-eyed needles," Marcus writes. The amendment, offered by Rep. Lois Capps (D-Calif.), does not require insurance plans in the exchange to cover abortion services, and such plans cannot discriminate against health providers who decline to provide abortion services. The amendment also requires that exchanges in each area of the country include at least one plan that does cover abortion services and one that does not. Plans that cover abortion services are required under the amendment to segregate a portion of their private premiums to pay for the service so that no federal funding is used for the procedure. According to Marcus, the "most questionable" and "politically vulnerable aspect of the Capps amendment involves the public plan." Under the amendment, if abortion is included among the covered services in a public plan, the procedure "can be financed only from a separate pool of purely private contributions -- as with the private plan" -- Marcus writes, adding, "This is even more stringent than the Medicaid rules under which states can use their own money to pay for abortions."

"It is hard to imagine how to craft a more sensitive approach" to the issue of abortion coverage "other than telling women who purchase insurance through the exchanges entirely with their own money that they cannot obtain abortion coverage," Marcus writes. However, "that would be perfectly fine with some of the critics," she continues, concluding, "Others are happy to seize on any argument, however misleading, that might derail the larger enterprise" (Marcus, Washington Post, 9/9).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

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