Policy-ish

Abortion Language In House Bill In Dispute

On Saturday night, before approving its landmark health bill, the House adopted an amendment offered by Rep. Bart Stupak, D-Mich., to tighten restrictions on abortion funding in the bill.

That much everyone agrees on. And that's about all everyone agrees on.

Supporters say it merely continues a long history of prohibiting federal funding of abortion. "Let us stand together on principle. No public funding for abortion, no public funding for insurance policies that pay for abortion," said Stupak on the floor.

But abortion-rights backers are calling it the biggest rollback of abortion rights in a generation.

So far 40 members of the House have signed a letter to House Speaker Nancy Pelosi saying Stupak's amendment "represents an unprecedented and unacceptable restriction on women's ability to access the full range of reproductive health services to which they are lawfully entitled," They are vowing to vote against any final bill that included the amendment in it.

So who's right? It depends how you crunch the numbers.

At issue is not so much banning federal funding for people in the government-sponsored public plan — that was pretty much a given — but in the new insurance "exchanges." These are the new marketplaces where individuals and small businesses will go to buy private insurance under the bills.

Under the Stupak language, private insurers in the exchange could not offer abortions to women who get public subsidies to buy their policies.

This is where the dispute comes in.

Abortion foes say plans could offer two different options — a plan with abortion as a benefit to people paying for their policies with their own money, and one without for those getting subsidies. But abortion-rights backers disagree.

"It is not clear that health plans would even be allowed to offer two separate plans under other provisions of the act, such as the anti-discrimination and guaranteed-issue provisions," says a memo from Planned Parenthood.

Meanwhile, the two sides are also sparring over how many abortions are actually paid for by insurance.

A 2003 study by the Guttmacher Institute found that 13 percent of abortions in 2001 were directly billed by abortion providers to private insurance. Abortion opponents say that shows that eliminating abortion coverage is not much of an issue. But the Guttmacher Institute itself points out that its numbers don't include women whose abortions were paid for by Medicaid (17 states cover Medicaid abortions using state funds); abortions for which women submitted their own reimbursement requests; or those paid for out of pocket.

A Guttmacher researcher told us that while the study did not collect any specific data on what types of abortions were reimbursed by insurance and what types were not, it was "logical" to conclude that more first trimester abortions performed in abortion clinics that cost only a few hundred dollars are self-paid, while more second-trimester abortions, that are often performed for fetal abnormalities or maternal health reasons in hospitals and can cost thousands of dollars, are reimbursed by insurance.

There is no exception in the Stupak amendment for either of those situations; only for abortions that directly threaten the life of the pregnant woman.

Comments

 

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Support comes from: