Congressional Abortion-Rights Supporters Wary Of Restrictions In Health Reform Legislation

Main Category: Abortion
Also Included In: Health Insurance / Medical Insurance
Article Date: 17 Nov 2009 - 3:00 PDT

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The issue of abortion coverage has put abortion-rights supporters in Congress at odds over whether to support health care reform legislation, the New York Times' "Prescriptions" blog reports. The House bill (HR 3962) that passed Nov. 7 includes an amendment prohibiting public and private insurance plans that receive federal subsidies from offering abortion coverage. However, the bill also would expand coverage to millions of people who lack insurance and end many gender discrimination practices, leading some abortion-rights supporters in Congress to question if they should "compromise on the issue and vote for legislation that in other ways could greatly improve health care for women," the Times' "Prescriptions" reports (Seelye, "Prescriptions," New York Times, 11/15).

The amendment, sponsored by Rep. Bart Stupak (D-Mich.), would prohibit a government-run insurance plan and insurance plans in the proposed exchange from covering abortion services except in cases of rape, incest or to save the life of the woman. Women who want such coverage could purchase separate riders. On Friday, House Speaker Nancy Pelosi (D-Calif.) said that although the amendment would restrict access to abortion coverage, allowing a vote was necessary to get the final bill passed in the House. She said those opposed to the language "were voting to get the ball down the field," adding, "If we all voted against (the bill), ... all those who wanted to kill health care would have their victory disguised as an abortion amendment" (LeBlanc, AP/Houston Chronicle, 11/14).

According to Robert Blendon, a professor of health policy at Harvard University, the choice between restricting abortion coverage in health reform and trying to improve other areas of health care has pitted "what are described as two fundamental human rights -- the right to universal coverage and the right of access to reproductive services -- against each other." He added, "They aren't just policy trade-offs. And that's why this is so wrenching."

Marcia Greenberger, co-president of the National Women's Law Center, said abortion-rights supporters should not have to choose between the two. "There is no reason why women should have to be asked to make trade-offs between having the basic right to coverage of their core health needs and the elimination of some of those unfair and discriminatory practices," she said ("Prescriptions," New York Times, 11/15). Cecile Richards, president of the Planned Parenthood Federation of America, said, "We're not going to have health care reform off the backs of women," adding that "this isn't what we've all spent our lives for" (Hirschfeld Davis, AP/Yahoo! News, 11/14).

Abortion-rights advocates are working to keep the House amendment out of the Senate health reform bill, with some House Democrats vowing to oppose the final bill if it contains the measure. Reps. Diana DeGette (D-Colo.) and Louise Slaughter (D-N.Y.), co-chairs of the Congressional Pro-Choice Caucus, said more than 40 House members have attached their names to a letter to Pelosi saying that they would vote against a final bill if it "restricts women's right to choose any further than current law." The names of those 40 members have not been released, according to "Prescriptions" ("Prescriptions," New York Times, 11/15).

During an appearance on CNN's "State of the Union" on Sunday, senior White House adviser David Axelrod would not say whether President Obama would veto a health reform bill that includes restrictions on abortion coverage. He said the issue, along with other controversial provisions, "will be worked through" as Congress continues debate. Axelrod added that Obama does not like the House language, noting that the president "has said repeatedly that he doesn't believe the bill should change the status quo as it relates to the issue of abortion" (Kurtz/Roth, Roll Call, 11/15). Obama will "work with the Senate and the House to try to ensure that, at the end of the day, the status quo is not changed," Axelrod said, adding, "There are discussions, ongoing, as to how to adjust it accordingly" (Hitt, "Washington Wire," Wall Street Journal, 11/15). Senate Budget Committee Chair Kent Conrad (D-N.D.) also appeared on the program, saying, "What is clear is that for this bill to be successful, there can be no taxpayer funding for abortion." He added, "Now, whether the House formula has got it quite right or not, that's open to debate. But what is clear is, to have legislation passed -- it was clear in the House; it will be clear in the Senate -- there cannot be taxpayer funding of abortion" (King, "State of the Union," CNN, 11/15).

Although Senate Democratic leadership has not announced how the abortion coverage issue will be addressed in the chamber's health reform bill, Senate Majority Leader Harry Reid (D-Nev.) said he remains confident that debate on the bill will begin before Thanksgiving, Roll Call reports. Reid is waiting for the Congressional Budget Office to provide a cost analysis, which did not come on Friday as he had hoped. It is not clear if Reid will wait 72 hours after the CBO score is revealed before a vote on the bill, as centrist lawmakers have requested (Pierce, Roll Call, 11/16). Appearing on "Fox News Sunday," Senate Minority Leader Mitch McConnell (R-Ky.) said that lawmakers should have sufficient time to read the bill before taking a vote on whether to proceed (Kurtz/Roth, Roll Call, 11/16). He predicted that the "issue will be hashed out on the Senate floor" (Hitt, "Washington Wire," Wall Street Journal, 11/15).

Democratic aides said Reid is prepared to push back his timeline and keep the Senate in session during the week of Thanksgiving to produce the 60 votes needed to block a GOP filibuster, which would prevent the bill from reaching the Senate floor. The aides also said they do not believe any member of the Democratic Conference will vote to block floor debate on the bill, Roll Call reports.

The issue of abortion coverage is expected to be a topic of discussion among senators this week as Reid looks for a consensus on whether to put the House language in the bill or allow senators to debate the issue on the floor, Roll Call reports (Roll Call, 11/16). If Democrats are unable to gather 60 votes, they have the option of scaling back the bill and trying to push it through under reconciliation rules that only require a simple majority, Politico's "Live Pulse" reports. However, reconciliation would limit the scope of the legislation by removing any policies that would cost money or produce no savings, according to "Live Pulse" (Frates, "Live Pulse," Politico, 11/13).

NPR Examines Possible Effects of Stupak Amendment on Private Market

NPR's "Weekend Edition Saturday" examined the potential impact the Stupak amendment would have on the private insurance market. Although the amendment would allow health insurers to offer abortion coverage to people who do not receive federal subsidies, most insurance experts say that is not likely to happen. Robert Laszewski, a health insurance industry consultant, said that approach would be "impractical" for insurers because a majority of people purchasing insurance in the health exchanges would receive subsidies and be unable to buy abortion coverage. Therefore, a separate plan that includes abortion coverage would be available to a small number of people, he said, adding, "It's about what is administratively simpler, easier to administer. It just adds a level of complexity [insurers] will likely avoid."

Another option for getting abortion coverage under the amendment would be through the purchase of separate riders, although experts say that is also not likely to happen, "Weekend Edition Saturday" reports. According to Laurie Rubiner, vice president of public policy and advocacy for PPFA, five states have similar policies in place. However, "we haven't been able to find any kind of separate abortion rider, and it doesn't surprise us because there's no market for it," she said. A woman does not "pla[n] to have a catastrophic pregnancy, or an unintended pregnancy," so she "doesn't think about buying coverage separately for abortion," Rubiner said (Rovner, "Weekend Edition Saturday," NPR, 11/14).

Los Angeles Times, Politico Examine Influence of Roman Catholic Church

The Roman Catholic Church has been able to participate in health care reform negotiations because of its support for Democratic health reform efforts, despite its staunch opposition to abortion rights and coverage, the Los Angeles Times reports. Earlier this month, the church's bishops used that negotiating power to push through the Stupak amendment, threatening to oppose the House's final bill if abortion coverage was not restricted.

However, many liberal Catholic organizations say the bishops do not speak for mainstream Catholics, the Times reports. A recent Catholics for Choice poll found that 68% of Catholic voters do not approve of the bishops' position on abortion coverage (Oliphant, Los Angeles Times, 11/16).

In related news, Politico reports that millions of Catholic swing voters who supported Democratic candidates in the 2008 elections could shift "just as readily" in the 2010 elections over the abortion coverage issue in health care reform. Obama won the support of 53% of Catholic voters, which is a seven-point increase from 2004, according to exit polls. However, "[t]hose gains will be at risk" if the Senate takes up the abortion coverage debate, putting many members of Congress in risky situations for re-election, Politico reports (Cummings, Politico, 11/15).

Washington Post, Los Angeles Times, Time Explain Stupak Amendment

The Washington Post on Sunday included a question and answer piece on the Stupak amendment and its possible implications (MacGillis, Washington Post, 11/15). The Los Angeles Times on Monday also included a Q&A on abortion coverage and other controversial topics in the House health reform bill (Geiger/Oliphant, Los Angeles Times, 11/16).

Meanwhile, Time on Monday traced the events leading up to the Stupak amendment and how the issue is dividing the Democratic Party (Sullivan, Time, 11/16).

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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