Interim Final Regulations Ban Abortion Coverage In High-Risk Pools

Main Category: Abortion
Also Included In: Health Insurance / Medical Insurance
Article Date: 02 Aug 2010 - 5:00 PDT

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The White House on Thursday announced interim final regulations for the new high-risk insurance pools that do not include abortion on the list of services that will be covered, underscoring President Obama's stance that abortion services will not be paid for with federal funds, except in cases of rape, incest, or life endangerment, CQ HealthBeat reports. The high-risk pools were created under the federal health reform law (PL 111-148) to provide temporary coverage to individuals with pre-existing conditions who are unable to get insurance. The program will run until 2014, when the health reform law will require insurers to cover those with pre-existing conditions.

In a blog post on the White House website, Nancy-Ann DeParle, director of the White House Office of Health Reform, said the list of services covered includes maternity care, hospitalization, outpatient care, home health care and hospice. The list of services that are not covered mirrors those also not covered by the Federal Employees Health Benefits Program. FEHBP prohibits the use of federal funds for abortion services, except in cases of rape, incest or to save the life of the woman. DeParle said, "This policy meets the president's commitment throughout the health reform debate to neither expand nor scale back current restrictions on federal funding for abortion and ensures that no federal funds will be used to cover abortion services other than the exceptions mentioned above."

The administration's announcement comes after several Republican senators demanded assurances from HHS Secretary Kathleen Sebelius that the high-risk pools would not cover abortion services. The senators cited a Congressional Research Service memo that questioned whether abortion services would be prohibited by the health reform law, an executive order signed by Obama and the program contract language (Norman, CQ HealthBeat, 7/29).

In the blog post, DeParle said, "Much has been made of this policy by both sides of the debate. But, in reality, no new ground has been broken." She added that the restriction on abortion coverage "is not a precedent for other programs or policies given the unique, temporary nature of the program and the population it serves" (Pecquet, "Healthwatch," The Hill, 7/29).

However, abortion-rights advocates argue that the requirement limits the use of private funds to purchase abortion coverage in the pools, which they say is allowed under the health reform law and Obama's executive order, Politico reports. They argue that the outright ban is more restrictive than the two-payment accounting rules included in the health reform law. The rules require women who purchase abortion coverage through public exchanges to make two, separate payments -- one for the abortion coverage and the other for the rest of the plan. Advocates argue that the requirements are burdensome and act as "a strong disincentive for abortion coverage," Politico reports (Kliff, Politico, 7/30).

The posting of the interim final rule on high-risk pools opens a 60-day public comment period, according to The Hill's "Healthwatch" (Pecquet, "Healthwatch," The Hill, 7/29).

Advocates Caught Off Guard

The controversy surrounding abortion coverage in the high-risk pools caught abortion-rights advocates "completely off-guard" and serves as "a reminder of the health reform battle they lost and a warning about the risks ahead," Politico reports. Laurie Rubiner, vice president for public policy at the Planned Parenthood Federation of America, said that the HHS decision "is not the outcome we expected." She said, "We now know we need to be vigilant to make sure there aren't other areas of the law where there is silence," adding, "There is a whole host of areas that we're going to be watching like a hawk."

The situation also reminds abortion-rights groups that "[h]aving a president on their side doesn't mean they can sit back and expect success," Politico reports. NARAL Pro-Choice America Political Director Elizabeth Shipp said the movement is experiencing "a triple whammy with Obama in office, a Democratic majority in Congress and, on top of that, there's the recession." She added, "It's really hard in this environment to get people ginned up about the importance of elections" and supporting candidates who advocate for reproductive rights. Laura MacCleery, government relations director for the Center for Reproductive Rights, said abortion-rights groups are "stuck in a slow backpedal," adding, "There needs to be a sense that, while health reform moves us forward, it moves us backward in terms of reproductive rights" (Politico, 7/30).

House Bill Would Codify Hyde Amendment

Meanwhile, Reps. Chris Smith (R-N.J.) and Daniel Lipinski (D-Ill.) on Thursday introduced a bill that would codify a ban on federal funding for abortion services under federal agencies, The Hill's "Healthwatch" reports. The ban -- known as the Hyde Amendment -- is passed each year as a rider to broader spending bills. It prohibits the use of federal Medicaid funds for abortion services except in cases of rape, incest or to save the life of the woman (Lillis, "Healthwatch," The Hill, 7/29).

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.

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