Health Care Bill Passes House, Now What?

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Sunday, the House passed the most sweeping health care legislation in decades. NPR's political editor Ron Elving explains what's next, and what the deliberations revealed about Congress. And the Washington Post's Amy Goldstein explains what the landmark bill means for you.

NEAL CONAN, host:

This is TALK OF THE NATION. Im Neal Conan in Washington.

After last night's drama in the House of Representatives, the health care bill that President Obama signs into law tomorrow promises to transform the way millions of Americans shop for and buy health insurance and who's covered.

And after many months of often bitter debate, last night's sometimes raucous session on the Hill, politics may be transformed, as well. We'll get to that in a moment.

But we want to focus on what's different. If you have questions about how this will change your health insurance and your life, give us a call, 800-989-8255. Email us, talk@npr.org. And you can join the conversation on our Web site. Thats at npr.org. Click on TALK OF THE NATION.

Later in the program, the Opinion Page, Patsy McGarry's piece on the pope's apology to the Irish people. You can read his piece in The Irish Times if you go to npr.org and click on TALK OF THE NATION.

But first, NPR senior Washington editor Ron Elving joins us here in Studio 3A, and Ron, thanks very much for coming in.

RON ELVING: Good to be with you, Neal.

CONAN: So last night, the House passed essentially two health care bills, and President Obama signs one of them tomorrow on the White House lawn.

ELVING: Yes, that would be the Senate bill, the bill that the Senate passed back in December with all of its flaws and unpopular features. The House had to pass that, as it was written by the Senate, with all those flaws, in order to then send it to the Senate to be modified by the House fixes in the form of a reconciliation bill.

So it has to be signed into law by the president tomorrow. So then it is actually law, and then the Senate can use its reconciliation procedures to adopt the House fixes, and the Senate Democratic leadership has told the House it has 52 votes to do so, which would be more than enough.

CONAN: Otherwise, it would need 60 votes to break a Republican filibuster.

ELVING: That is correct.

CONAN: Following the election of Scott Brown in Massachusetts, it no longer has 60 votes. There you go. Anyway, so the Senate will debate this measure when?

ELVING: The Senate will actually debate the measure after the president has signed it into law, but they won't be debating the measures that they passed back in December. That will be law. What they'll be talking about are the proposed changes that the House wants to make, now called by many, the fixes -and these fixes would be made through the reconciliation process.

They will have 20 hours of debate, equally divided between the two parties. They could get that done this week, and they could proceed to vote this week, but we know that the Republican Party is still intent on doing whatever it can to dis-rail derail or disrupt this process.

And so they are going to bring up a number of points of order under something called the Byrd Rule, which we can go into if there is (unintelligible), which would reinstitute the 60-vote threshold and make it much more difficult for the Democrats to proceed. And I suspect that they will bring those points, and some of those points will be considered by the Senate parliamentarian, and some of them could be seen as legitimate points, and they could make changes in what the House is proposing, which would mean some of this would have to go back to the House for another round.

CONAN: And someone would have to scrape Speaker Pelosi off the ceiling because she does not want to go through this again.

ELVING: I am sure that is correct.

CONAN: Right. Let's presuming that this all goes forward, it's interesting, because the politics of this - remember the there was one point when we're going to make health care President Obama's Waterloo. That was the pledge, and indeed now the president has gotten it through.

ELVING: That is correct, and there are many Republicans who believe it will be his Waterloo, that it will be a bill that the president cannot escape, that it'll be an albatross, that it'll be terribly unpopular and that by November, the voters will be looking to someone on whom to take revenge, and since the president won't be on the ballot in November but a lot of Democrats will, all the Democrats in the House who want to be re-elected will be. A great number of the senators, I believe 18 Democratic seats are on the ballot in November. So there'll be a lot of targets for people who are angry at Democrats.

The Democrats say: Let's wait and see just how unpopular this bill is in the months between now and November.

CONAN: Last night during the House debate, Republican Paul Ryan of Wisconsin was among those who vowed there would be political consequences.

Representative PAUL RYAN (Republican, Wisconsin): On this issue, more than any other issue we have ever seen here, the American people are engaged. From our town hall meetings to Scott Brown's victory in Massachusetts, you have made your voices heard, and some of us are listening to you.

(Soundbite of applause)

Rep. RYAN: My colleagues, let's bring down this bill and bring back the ideas that made this country great.

(Soundbite of applause)

Unidentified Man: Gentlemen, (Unintelligible).

CONAN: The gavels, the motions, the unanimous consent parades, it was all such an interesting evening to watch, yet it was also a raucous evening, not just on the floor but outside the Congress, as well.

ELVING: Indeed. There were thousands of protestors, some of whom had been to the Capitol before, to the Capitol grounds before, even during the past week, lobbying against the bill, both outdoors and indoors, going to many of the members' offices, trying to get people to vote against the bill. And many of them stuck around through the weekend.

Now, it was a beautiful weekend in Washington. We had a march against the wars in Afghanistan and Iraq. We had a much larger march in favor of immigration, a comprehensive immigration overhaul bill. These were people who would like to see a path to citizenship for current illegal immigrants. And there were many other people in Washington, too, but the protestors who were getting all the attention were the ones most of the attention - were the ones up on the Hill who were, in many cases, lining the street pathway between the office buildings and the Capitol.

Now mind you, members of the House can go underground. They have tunnels. So they could go from the office buildings into the Capitol. That is quite typical. Any kind of bad weather, that's what they do. But they marched across in full sight of these protestors. They wanted to be visible.

Nancy Pelosi got a big ceremonial, enormous gavel to carry. It made her look like a character out of "Alice in Wonderland." And the protestors were angry, and they were shouting. They shouted, in some cases, according to many witnesses, racial epithets. We don't have any on tape.

We don't have that kind of evidence of this, but many observers and many members of Congress testified to that. Homophobic things were shouted. But most of the protestors were sticking to the issues: Please kill this bill. Please don't impose your idea of health care on the country. And this obviously was energizing to the Republican minority, and it was, I suppose, in some degree, discouraging or maybe even intimidating to some of the people who were planning to vote for the bill.

But as far as we can say, as far as we can see, it didn't actually change anyone's vote.

CONAN: And it remains to be seen whether that kind of energy can be sustained until November and election day, and even on into 2012 and the presidential the president's hopes of being re-elected.

Meanwhile, there are a couple of other things that might stop the bill, kill the bill, if you will. There are lawsuits. Bill McCollum of Florida, the attorney general there, former member of Congress, announced today a lawsuit that says this is unconstitutional, and he is just one of many attorneys general who hopes to file suit in federal court.

ELVING: That's right. The attorney general in Virginia is talking about doing it, too, once the bill has been signed into law. I believe there will be many such suits that say that the bill has fatal flaws and does not have to be respected either by the individual states or by any of the 50 states, by anyone in the United States.

There's a couple of different lines of argument here. One is that the states just don't have to follow something like this, when the federal government sets it up. That's known as nullification. It is an issue much tested in American history, back to Andrew Jackson, certainly Abraham Lincoln, the whole issue of the Civil War.

I don't think they're going to get far with that. A lot of states tried to do it with the civil rights legislation in the 1960s with school desegregation in the 1950s. I don't think we're going to get very far with nullification.

On the other hand, they're going to raise the issue of whether or not the federal government can, as it does under this legislation, mandate that individuals get health insurance.

That is a more interesting question because we haven't had that one before, and we're going to see how the courts deal with the question of whether or not the federal government can require people to do this kind of thing.

CONAN: Obviously, state governments require you to do that if you want to drive a car.

ELVING: That is correct, and I believe there are many other precedents, as well, in the law, but this is a particular animal that has not yet entered the zoo, and so when it does, I think the courts will have a look at it. I would be somewhat surprised if this turns out to be a magic wand that, once waved, will make all of this go away. I suspect it won't, but that is constitutional question to be resolved by the courts, and we're going to be looking at that.

And the third thing, of course, is the Republicans are going to immediately start putting in bills trying to repeal what has been passed, and should they improve their political position in the November elections, we'll see a lot more of that a year from now.

CONAN: And nullification, which you mentioned, is the states basically saying you may have passed a law; we're not going to pay any attention to it.

ELVING: Exactly.

CONAN: All right. Now, we have learned a lot about health care and about this bill over the past many months. What have we learned about Congress?

ELVING: There are some interesting things going on in Congress right now because the not only is the president pressing for an ambitious agenda on many fronts financial re-regulation; climate change; the wars, of course, trying to change policy there; this health care bill; immigration many different things the president is pressing for. And the Republican Party has, in a way that may be unprecedented in our history, in its purity, if you will, taken a unified position against all of it.

And they are almost perfectly aligning their people for no votes, procedural votes, delaying tactics, doing everything they possibly can, including using the filibuster in the Senate against almost everything that the Democrats attempt to do, even fairly routine business, even appropriations bills they don't have a problem with - doing this as a kind of massive resistance to the president's program.

So an unusual presidential situation, an unusually large Democratic majority in the House and Senate, about 59 percent of the seats in both chambers, and then an unusually unified and strong and, if you will, driven Republican massive resistance strategy to resist all of it.

CONAN: This is is this a reflection of the it was interesting. You mentioned the protestors outside the House last night. There were Republican members of the House of Representatives going up to a balcony, waving them on, egging on the demonstrators, saying we are with you, kill the bill, and really grasping - trying to grasp this political moment.

ELVING: That's right. I think we've all talked a lot about the Tea Party movement. We've talked about the spirit of, if you will, conservative populism that has animated that particular movement that's been visible throughout the country, starting about a year ago, to some degree, with the birther movement and taking off in the summer with the town halls and so on.

It has an intensity we haven't frequently seen on the right, but I would say this, that after the election of John Kennedy and after the election of even Jimmy Carter, certainly after the election of Bill Clinton, in each of those instances over the last 50 years, and certainly, of course, now again with Barack Obama, the election of a younger and at least measurably more progressive president after a period of Republican presidency, has led to a big shift in the intensity of oppositional energy around the country. So that instead of seeing a lot of agitation on the left, we suddenly see a lot of agitation on the right, and it takes on an unusual degree of intensity for a conservative moment, conservative movement, and that, I think, gets a lot of attention from the media and from the rest of the body politic.

CONAN: Ron Elving, we will be tracking that wave, from now until November, and indeed until November, 2012. I guess we'll start Wednesday with the Political Junkie, when Ken Rudin will be in that chair, but thanks very much for being with us today.

ELVING: Thank you, Neal.

CONAN: And when we come back from a short break, we're going to be talking, not about the politics for once, but about how this bill let's presume the Senate version of the House fixes all passes, and everything gets signed, a big assumption, but let's assume that. If that's the bill, how does it change the way you get your insurance? How does it change your life?

If you have questions for us, give us a call, 800-989-8255. Email us, talk@npr.org. Amy Goldstein of the Washington Post will be with us. You stay with us, too. I'm Neal Conan. It's the TALK OF THE NATION from NPR News.

(Soundbite of music)

CONAN: This is TALK OF THE NATION. Im Neal Conan in Washington.

The health care bill that passed the House yesterday, with the fixes, would require almost everyone to be insured or pay a fine. Subsidies will help if you earn up to four times the federal poverty level. Medicaid would be expanded. New insurance exchanges are going to be set up to help those without insurance buy their own.

If you have questions about how this law will change your health insurance and your life, give us a call, 800-989-8255. Email us, talk@npr.org. And you can join the conversation on our Web site. Thats at npr.org. Click on TALK OF THE NATION.

To help us understand all of this and what it might mean for all of us, Amy Goldstein is with us, national reporter for the Washington Post, who has been steeped in health care for lo, these many months, and she's been kind enough to join us here in Studio 3A. Amy, nice to have you back on the program.

Ms. AMY GOLDSTEIN (National Reporter, Washington Post): Good to be with you, Neal.

CONAN: And why don't we get right to some questions from callers. We'll begin with Kevin(ph), and Kevin's calling us from Berkeley.

KEVIN (Caller): Hi.

CONAN: Go ahead, Kevin.

KEVIN: I'd like to know what issues, what specific policy issues, are yet to be decided in the bill. And for instance, what will be the subsidy level for various incomes, and what will be the fine?

CONAN: The fine if you don't buy the health insurance?

KEVIN: That's right.

CONAN: All right, why don't we stop right there, give her a chance?

Ms. GOLDSTEIN: Well, between the Senate bill that passed last night and the House's fixes, as Ron Elving was just saying, that the Senate still needs to pass, pretty much everything is decided, assuming the Senate goes along. And between those two bills, there are both subsidies and fines.

So to start with the fines, this would be the first time in American history that the federal government requires, not everybody, but most people to have insurance, and to try to motivate people to do that, there would be fines. Like many of the really important provisions of the bill, these would not start for three four years, until 2014, and starting that year and then they would be phased up over a couple years.

So to start with in 2014, the penalty would be either $95 or one percent of people's income, whichever is greater, and then by 2016, so it would be phased in just over two years, the fine would become $695 or 2.5 percent of people's income.

Now, people who are really very low income would be exempt from these fines. So would a few other groups, including American Indians. But one of the big policy questions, even though the structure of these bills is all foreordained, is how many people would get coverage and how many would decide that it's worth pay the fines in order not to get coverage? And it's going to take some time for that to play out.

KEVIN: My understanding is that in Massachusetts, very commonly, people would simply choose to pay the fine, and then when they got sick - because they couldn't be refused insurance for any reason - when they got sick then they would buy insurance.

CONAN: Is that likely? Well, that's speculative, but is that open to people?

KEVIN: That's not speculative...

CONAN: Not speculative in Massachusetts.

KEVIN: Just if it would happen here.

Ms. GOLDSTEIN: Well, it's an interesting point that you raise and an interesting state that you raise because Massachusetts is the one place in the country that's already enacted something most akin to what the federal government's now envisioning.

And if I recall what happened in Massachusetts, the fines also grew over a period of years, and at the beginning, as you were suggesting, there were a number of people who chose to pay the fines rather than to get the coverage. But over time, as the fines grew steeper, even though there were still some people who said I'm not going to do this, that number shrank.

CONAN: Thanks very much, Kevin. Let's go next to Jen(ph), and Jen's with us from Boise.

JEN (Caller): Hi, Neal, thanks for taking my call.

CONAN: Sure.

JEN: My husband and I both work, and my health insurance, we pay for out of pocket, and it's always been our income is around $30,000 a year, and we have two kids, and they're both on Medicaid, thankfully. But my insurance has been expensive because I have clinical depression. And so my question is just that, even with a subsidy, if we qualify for that, is the price going to be still so much that...

CONAN: Oh because of the pre-existing condition?

JEN: Yeah because it's a pre-existing condition. Are we still going to be priced out of it, even with a subsidy, or is the insurance going to be decent coverage?

CONAN: Amy Goldstein?

Ms. GOLDSTEIN: Well, there are a couple things that you raise in your question, and let me just step back before I get into the specifics of your question. The way that this bill would help people get coverage has two parts.

If you have incomes - an income up to about, close to $30,000 for a family of four but not quite $30,000, you would qualify for Medicaid. So in most parts of the country, that's a lot more generous Medicaid eligibility than exists now.

Now, if you don't qualify for Medicaid, starting at, as I said, just under $30,000 or 133 percent of the poverty level, what you would qualify for is a new kind of federal subsidy that would help you buy coverage on your own.

And the idea is that coverage would be two things: One, a lot of the insurance practices, including making things difficult for people who are already ill, would be much harder for the insurance industry to do; and for people who have been buying coverage really on their own, in other words not with a big company, they would be able to get coverage through this arcane-sounding thing called an exchange that you probably heard talked about, which is basically a state-run insurance marketplace in which people who are buying coverage - would otherwise be buying coverage individually, kind of get lumped together, and the idea is that their insurance rates would be less expensive as a result.

JEN: Okay.

CONAN: Okay.

JEN: Thank you for your answer.

CONAN: And good luck. I think we heard some of those children in the background, Jen. Good luck with them.

JEN: Thank you, bye.

CONAN: Here's an email question from Bob(ph) in Portage, Michigan. I understand that most, but not all, Americans will have access to health care insurance. I know that illegal aliens and prisoners are excluded. Are there other categories that are excluded? Will foreign students or people here on travel visas have access? If so, would they be subject to the mandate?

Ms. GOLDSTEIN: Well, that's a good question to which I don't know the specific answer. But the two groups that the writer mentions, prisoners and people are not in this country legally, are the main groups that would be exempt.

The other groups, of course, are people who, as we said a moment ago, have very low incomes. They would not be expected to pay for coverage.

CONAN: Let's go next to Joe(ph), and Joe's with us from Cedar Hill in Missouri.

JOE (Caller): Yes, thank you for allowing me to speak on such a prestigious platform.

CONAN: Oh, well, that's okay, Joe. Go ahead.

JOE (Caller): Okay. Can we just think about the Cadillac option in the what passed?

CONAN: So at one point or another, Congress was considering taxing so-called Cadillac plans. These are health plans that a lot of union members have, for instance, and this is why the unions were opposed to that particular provision. Amy Goldstein, what happened there?

Ms. GOLDSTEIN: Well, those taxes and what Cadillac plans refer to are very expensive insurance policies. So the premise of this was to take people who have really high-end coverage and make them pay a little bit to help everybody else get coverage. And as you say, the unions were very opposed to that.

In the end, and the House actually likes the idea more than the Senate and more than President Obama. So in the end, those taxes, called excise tax, still exists. It's not going to start until later than it would have otherwise. It'll start in 2018, which is a few years after the House bill would've had it start, and the tax is going to be a little bit less, but it still exists.

CONAN: It still exists, and how onerous is it?

Ms. GOLDSTEIN: Well, that's a matter of opinion.

CONAN: Okay, Joe. Joe?

JOE: An addendum to that would be, is the health care plan that the Congress enjoys, which is a very beneficial plan for them, is that exempt from this Cadillac rule?

Ms. GOLDSTEIN: I don't think it qualifies. I'm not absolutely sure about that, but I don't think that reaches quite the level of generosity as the plans that would be caught up in these taxes.

It sounds like you've got some strong opinions. Maybe you're not a big fan of this tax.

JOE: Oh, I'm just asking questions, and the last one would be, if I may: You mentioned that there are penalties for not buying the coverage.

Ms. GOLDSTEIN: That's right.

JOE: Yeah, you didn't elaborate on how those would be adjudicated.

CONAN: Oh, they're imposed by the Internal Revenue Service, correct?

Ms. GOLDSTEIN: That's right.

JOE: Okay, since the state of Idaho has already passed a Freedom of Health Care Act, exempting the Idaho citizens from the mandatory clause, does that take the teeth out of the IRS' bite, or how is that going to work?

CONAN: Well, that's going to have to be adjudicated by the courts, who are going to have to decide whether that's a constitutional issue. So we'll have to wait to see what happens with that, Joe.

JOE: Thank you.

CONAN: All right, thanks very much for the call. Let's go next to this is Pam(ph), and Pam's with us from Santa Rosa Beach in Florida.

PAM (Caller): Hello.

CONAN: Hi.

PAM: Right now, my husband is self-employed, and I stay at home with our kids, and our health insurance plan is one of the catastrophic ones, where we have low monthly premiums, but really high deductible.

CONAN: But a huge deductable, yeah.

PAM: Right. And I was just wondering if we would be able to get a better plan if we were that maybe we'd have to pay a little bit higher premiums, but we would have better coverage.

CONAN: Well, these would this would presumably offered in one of these exchanges. Amy Goldstein, if you could explain.

Ms. GOLDSTEIN: That's right. Let me ask you I hope this isn't too personal a question. Do you mind telling us roughly what your income level is?

PAM: It's about $80,000 a year.

CONAN: The IRS is not listening.

Ms. GOLDSTEIN: Okay, well, that matters because as we were just saying, you would be able to buy coverage through an exchange. And the idea is that that would be probably better coverage than the kind of catastrophic or barebones policy that you and your family has right now.

PAM: Right.

Ms. GOLDSTEIN: And it was supposedly be a little bit less expensive because more people are being pulled together, so your personal medical risk wouldnt be so much a factor in deciding what your...

PAM: Okay.

Ms. GOLDSTEIN: ...premiums would be. But because you're below about $88,000, you would get probably a little federal subsidy. The subsidies go up to about $88,000 for a family of four. The subsidies are much less at that upper end than they are for people who are closer to the Medicaid eligibility level of 133 percent poverty. I think you'll get a little something.

PAM: Okay. Okay. Thank you so much.

CONAN: Thanks for the call, Pam. Is the assumption here that most of the - we keep hearing different numbers: 30 million, 32 million, whatever it is - those who would be incorporated in this plan that most of those people are healthy and do not buy health insurance because they don't think need it.

Ms. GOLDSTEIN: Well, that's part of the premise. Let me come at the question in a couple of different ways, which are how would those people presumably get covered.

CONAN: Mm-hmm.

Ms. GOLDSTEIN: And slightly less than half of those people would get covered through these expansions of Medicaid. So that's at the low income of people's wages. The rest would get covered through these exchanges. The figures that I've seen - I hope I'm not throwing too many numbers here, but to give people a feel - the Congressional Budget Office, which did a big analysis of how they think this would all work. Of course, it's not going to be completely clear how it will work until it starts. But the Congressional Budget analysts think that about 24 million people would get covered through these exchanges. Of those, about perhaps 19 million would get at least some subsidy.

CONAN: If you joined us late, President Obama plans to sign the so-called Senate bill tomorrow on the White House lawn. After that, the Senate will take up the fixes that were also passed by the House of Representatives last night. And if the Republican plans to derail those fixes, or change those fixes, or subject them to some kind of procedure fail, then they will be adopted by the Senate and a new bill will be presented to the president of the United States with the fixes present - approved by the House of Representative last night. And we will have the final health care legislation. In any case, that Senate bill is going to be law tomorrow once the president signs it.

So we're talking with Amy Goldstein of The Washington Post about what changes -we're assuming for a minute the House fixes are going to be passed. How does it going to change your life? You're listening to TALK OF THE NATION from NPR News.

And let's go next to David(ph), and David is with us from Nashville.

DAVID (Caller): Yes. I have a Medicare supplement plan. And when my Medicare Part B premium went up, I went shopping and found Medicare supplement. Now this is subsidized and the subsidy will disappear. The fact of the matter though, it was - it saved - it filtered down to the consumer, and my premium went away. So I - well, I saved $120 a month, I think, on premium, not to mention the other benefits in this program like the SilverSneakers. And that's a concern because it's going to add the cost. And the other concern is - the other question is, when will this go into effect?

Ms. GOLDSTEIN: I've got an important question for you. Are you getting Medicare through the original version of the program or through a private health plan, which is called the Medicare Advantage part of the program?

DAVID: The advantage, Medicare Advantage.

Ms. GOLDSTEIN: Okay. Well, that will change. Since 2003, when Congress added prescription drug benefits to Medicare and it also created Medicare Advantage at the same time, there's been a lot of debate about whether the reimbursement rates that are paid to those private health plans are proper or too high. And the health insurers have been saying for years that those rates are justified, Republicans have been agreeing with them, and Democrats have been just waiting for a chance to lower those rates. And that's going to happen under this law.

Now, what the effect of that is going to be in terms of how many private health plans will continue to want Medicare patients, whether it'll be marketing aggressively still to new patients - I mean, all that's going to have to play out over a period of time. So what happens to your specific benefits, I think it's a little hard to know before this all takes effect.

CONAN: Will they, in general, be lower?

Ms. GOLDSTEIN: The rates will be lower, which means that health plans will be paid less, so they may have less interest in taking older patients.

CONAN: So doctors will have less interest in taking older patients?

Ms. GOLDSTEIN: Well, those will be the private health plans, not the doctors themselves.

CONAN: Okay. I see. All right. David, good question. Thank you.

Here's an email that we have - no name or city - but interesting question. I had a miscarriage and D&C in January that was largely covered by my health insurance. I was grateful not to have to worry about the cost of the procedure during what was obviously a difficult period. In a related vein, a friend had an abortion at 16 weeks after her fetus was diagnosed with a severe genetic abnormality that made it unlikely to survive the pregnancy, even if it did made it unlikely that a newborn would die within days or weeks.

I am confused by the back and forth that's led to the executive order on abortion. How will the new bill affect women in my situation and my friend's situation? Will we now face high upfront costs or perhaps no reimbursement at all during what is already a difficult time? The executive order issued by President Obama last night to reassure Democrats like Bart Stupak who eventually came around and supported the bill.

But if you could - if you have an answer for us, Amy?

Ms. GOLDSTEIN: Well, the whole question of how this law would treat abortion services has been a very big political fight. It's actually been a kind of small part of the bill, unless you happen to need abortion services, but it's been an outsized political fight. And in the end, the president wanted to assure some of the Democrats, some of the conservative Democrats like Mr. Stupak from Michigan, that there was nothing subtle in the bill that would allow federal funding for abortion to creep in more than the bill language itself look like on the surface. So that was the reason for that last-minute executive order that was announced yesterday.

Now, under this law - again, we're assuming it all becomes law - private health insurance companies could choose to, in states that allow it, offer abortion services. But through a funny little wrinkle in the law, the money to cover those services would have to be collected separately. And there's been a lot of discussion about whether insurance companies would go to the trouble of collecting that, or whether it would be easier simply not to include that service as part of the coverage package.

CONAN: So it might have the effect of denying people abortion coverage?

Ms. GOLDSTEIN: Well, it might, or might not. I mean, that's another one of those things like a lot of its law that how it plays out in practice is going to take awhile to determine.

CONAN: Well, Amy Goldstein, thank you very much for being our guide and answering our listeners' questions. I'm sure we may have a few more for you down the road.

Ms. GOLDSTEIN: Good to be with you.

CONAN: Amy Goldstein is the national reporter for The Washington Post and was kind enough to join us here in Studio 3A.

Coming up on the Opinion Page this week, reaction to the pope's apology to Irish Catholics after decades of sexual abuse and cover-up, was it enough? Patsy McGarry will join us from Dublin.

I'm Neal Conan. Stay with us. It's the TALK OF THE NATION from NPR News.

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