Issue Of Abortion Coverage Complicates Health Reform Battles, New York Times Reports

Main Category: Abortion
Also Included In: Health Insurance / Medical Insurance
Article Date: 30 Sep 2009 - 4:00 PDT

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Debate over abortion coverage under health reform has upped the complexity of an already complicated legislative battle, with antiabortion-rights lawmakers in both chambers threatening to block reform measures if they do not include new restrictions on the use of federal subsidies to purchase health coverage, the New York Times reports. According to the Times, the antiabortion-rights lawmakers are "getting enough support from moderate Democrats that both sides say the outcome is too close to call." President Obama has said that health reform would not provide federal funding for elective abortion services, though White House officials have not elaborated on the specifics. The "question looms as a test" of Obama's campaign pledge to support abortion rights while trying to find common ground with those opposed to abortion rights, according to the Times.

The Times reports that Democratic leaders in Congress say the most recent versions of health reform bills "preserve the spirit" of existing restrictions on federal funding of abortion by requiring insurers who decide to cover abortion services to separate federal subsidies and individual premiums into different accounts. Abortion services could only be paid for with funds from the account of private sources. Advocates of this model note that 17 state Medicaid programs that cover abortion services with their own funds use a similar system, separating federal funding from state revenues. The current health reform bills also provide that every health insurance exchange should have available at least one plan that offers abortion coverage and at least one that does not. Rep. Rosa DeLauro (D-Conn.) said that the "language of the compromise is very clear," adding that "it prohibits the use of federal funds to pay for abortions." However, abortion-rights opponents claim that even though the funds are separated, federal subsidies would still help people better afford health insurance that includes abortion coverage.

Abortion-rights supporters argue that restricting the use of subsidies for insurance plans that offer abortion coverage would remove private plans that cover abortion services from the marketplace. According to a Kaiser Family Foundation study, about half of employer-sponsored health insurance plans currently cover abortion services. Nancy Keenan, president of NARAL Pro-Choice America, said that private insurers would stop covering abortion services if health reform legislation prohibits federal subsidies to plans that provide abortion coverage. She added that women "who already have this coverage would lose it."

Vote on Hatch Amendment Expected This Week

The Senate Finance Committee is expected to vote this week on an amendment by Sen. Orrin Hatch (R-Utah) that would prohibit federal subsidies to health plans that offer abortion coverage. Under Hatch's amendment -- as with a House proposal being pushed by Rep. Bart Stupak (D-Mich.) -- plans would be allowed to charge women an additional premium for an insurance "rider" that covers abortion care. Both sides of the debate have said that if the committee does not vote to include Hatch's amendment, they expect "a very close contest over the issue" when the bill reaches the Senate floor, the Times reports. Democratic Sens. Bob Casey (Penn.) and Ben Nelson (Neb.), both of whom oppose abortion rights, are pushing the issue, according to the Times. In the Senate Health, Education, Labor and Pensions Committee, Casey voted for a proposal to restrict the use of federal subsidies that was defeated by one vote.

Nelson is considered a crucial vote to pass the health reform bill, and he "does not believe that taxpayer dollars should be used in any way to fund abortion," his spokesperson said. Senate Majority Leader Harry Reid (D-Nev.) believes the most recent drafts of the health reform bill already meet that goal, Jim Manley, a Reid spokesperson, said.

Stupak Leads House Opposition

According to the Times, at least 31 House Democrats have signed various letters to House Speaker Nancy Pelosi (D-Calif.) urging her to allow a vote on an amendment to restrict the use of federal subsidies for abortion. Twenty-five of those signers joined more than 100 Republicans in a letter delivered Monday. Stupak said he has commitments from 40 Democrats to block the House health care bill (HR 3200) unless they have the opportunity to include the restrictions.

Stupak said he and Pelosi have scheduled a meeting on Tuesday to discuss his proposals -- including the rider -- for the first time. Nadeam Elshami, a spokesperson for Pelosi, said the speaker is "meeting with our members to listen to their concerns, consulting with the administration and making progress." Stupak also said that he received a call from Obama 10 days ago, after months of pushing the abortion-coverage issue. He said Obama told him, "'Look, try to get this thing worked out among the Democrats. We want you to work it out within the party.'" Stupak said Obama did not say if he supported the segregated-money model or broader restrictions (Kirkpatrick, New York Times, 9/29).

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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