A new frontier in the abortion wars: health insurance
By Garance Franke-Ruta
Abortion insurance: Until the debate over reforming health-care, who'd ever heard of such a thing?
"I laid out a very simple principle, which is this is a health care bill, not an abortion bill," President Obama said this week after the House passed legislation that barred coverage of elective abortions through either federally supported insurance or private plans purchased with federal subsidies. To get such insurance coverage, women would have to seek out and purchase supplemental plans, known as abortion riders.
Abortion-rights advocates hope that the provision, sponsored by Bart Stupak (D-Mich.) and Joe Pitts (R-Pa.), will yet be stripped from the final bill or at least be modified to apply only to the public plan, leaving private plans purchased with federal subsidies untouched.
If it is not, some fear the amendment could have reverberations across a wide swath of the private insurance market, as insurers increasingly drop abortion coverage -- for those who do not need public subsidies as well as those who do -- when they offer policies through the exchanges.
Others worry that the Stupak amendment is the first salvo in a bid to ultimately restrict abortion coverage in insurance policies. "This would be the biggest restriction on womens' right to choose in my career," Congressional Pro-Choice Caucus co-chair Rep. Diana DeGette (D-Co.) told TPMDC.
Whatever happens with the bill itself, the Republican National Committee's decision Friday to stop offering its staffers insurance coverage for abortions suggests that the issue of private insurance for abortion will continue to resonate in new ways politically, now that it has been spotlighted on the national stage.
"News reports have revealed that the RNC's health plan dating back as far as 1991 may have included some coverage for elective abortion. Upon learning of this, Chairman Michael Steele instructed the RNC Director of Administration to opt the RNC out of any coverage for elective abortion services in its health insurance policy," RNC spokesperson Gail Gitcho said in a statement Friday.
Steele said that was the end of the matter. "Money from our loyal donors should not be used for this purpose. I don't know why this policy existed in the past, but it will not exist under my administration. Consider this issue settled," he said.
But the issue is far from settled for some who oppose abortion, who were furious to learn that the RNC offered a policy seemingly out of sync with its values.
"For thirty years, we have fought tooth and nail to prevent our tax money from being used to pay for abortions. Turns out, we were apparently doing it through donating to the political party that was ostensibly on our side. This betrayal is so fundamental to the majority of people who donate to the RNC that it's almost unspeakable," wrote Leon H. Wolf at RedState.com. "I have no doubt that many of the staffers there will miss the point, so allow me to make it clearly: you have caused every person who donated to support your livelihood to become involved in what they perceive to be a grave moral evil."
Douglas Johnson, the legislative director of the National Right to Life Committee, said that the issue of private-sector insurance coverage has "not been something we've tried to limit at the federal level" but that the questions that have been raised by the debate in Congress are likely to have a positive impact.
"I thought this was a good side effect of the debate over the Stupak amendment," he said, "...that people would start asking, 'Hey, is our plan covering abortion?' Because a lot of people are probably paying for it who don't want to be."
At present five states -- Idaho, Missouri, Kentucky, Wisconsin and North Dakota -- have bans on private insurers of various kinds providing coverage for elective abortions. Others, such as Obama's home state of Illinois, do not provide abortion coverage to state employees. Only a fraction of abortions in states with bans on private insurance coverage are covered by the riders, which are not offered in all five states.
In Missouri, where the ban on insurer coverage has been in place since 1983, Paula Gianino, president and chief executive for Planned Parenthood of the St. Louis Region, told the St. Louis Beacon that just 7 to 10 percent of abortions performed at its clinic in St. Louis were covered under abortion riders.
Nearly half of women with private health coverage are covered for elective abortions, according to a 2003 Kaiser Family Foundation study. A 2002 Guttmacher Institute study assessing levels of insurance coverage found that "87 percent of typical employer-based insurance policies in 2002 covered medically necessary or appropriate abortions." Another Guttmacher study from 2001 found only 13 percent of women receiving abortions filed claims at the medical site with their insurers seeking reimbursement.
Because that figure includes women who lacked insurance, were on Medicaid or sought reimbursement from insurers off-site, Guttmacher has cautioned against using it to argue that "because very few women use private insurance coverage to pay for abortion services, loss of this coverage would have minimal impact."
November 13, 2009; 8:56 PM ET
Categories: Health Care , The Debate Rages On...
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