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Wednesday, November 11, 2009

The American Prospect: Democrats Leave Women Behind

by Michelle Goldberg November 10, 2009 

We've reached a point where health-care reform threatens to leave access to abortion in worse shape than it is right now. The Stupak Amendment, added to the health-care bill in last-minute negotiations this weekend, goes beyond the existent ban on federal funding of abortion. By prohibiting anyone receiving federal health-insurance subsidies from buying plans that cover abortion, it's almost certain to compel many plans to drop abortion coverage for everyone.



Almost all progressives have realized that passing health-insurance reform was going to require some bitter compromises. But it's both maddening and heartbreaking that a pro-choice president and a Democratic Congress are poised to give the anti-abortion movement its biggest legislative victory since 2003's Partial Birth Abortion Ban Act.

Right now, most employer-based health insurance plans cover abortion. The reason for this is depressingly mercenary -- it's cheaper for insurance companies to pay for a termination than for prenatal care and delivery. Motives aside, though, this coverage is crucial, given that abortion is among the country's most common medical procedures. Congressman Bart Stupak's amendment threatens it even for women who buy insurance themselves or get insurance from their employers.

The Congressional Budget Office estimates that if health-care reform passes, by 2019, 21 million people will buy insurance on health-insurance exchanges. About 80 percent of that number will have some sort of subsidy from the federal government, and so any plan that wants its business can't offer abortion.

To be sold on the exchanges, a plan offering abortion coverage "would have to explicitly be marketed for people who aren't eligible for subsidies," says Adam Sonfield, senior public policy associate at the Guttmacher Institute. "We're looking into whether that's even legal. We're not sure it is -- it sounds very much like discrimination on the basis of income."

Nor does this just affect individuals purchasing insurance. The exchanges will offer coverage to small businesses as well, and they're intended to expand to larger and larger businesses as time goes on. Thus the Stupak Amendment means that the more successful health insurance reform is, the more women will lose access to abortion coverage.

The amendment's supporters and apologists are downplaying its scope by noting that, according to the Guttmacher Institute, only 13 percent of abortions are currently billed to health insurance. But that's misleading, because it doesn't include women who file for reimbursement after seeking an abortion from an out-of-network provider -- and, as Sonfield points out, most providers are out of network.

See the complete article at http://www.prospect.org/cs/articles?article=democrats_leave_women_behind

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