Here's what it says:
The amendment will prohibit federal funds for abortion services in the public option. It also prohibits individuals who receive affordability credits from purchasing a plan that provides elective abortions. However, it allows individuals, both who receive affordability credits and who do not, to separately purchase with their own funds plans that cover elective abortions. It also clarifies that private plans may still offer elective abortions.
There's been a lot of debate around here about what that exactly means. Here's what it means. Millions of women will not have access to a legal medical procedure. Remember that, the legal part?
What's the harm, some say? It only makes sure that federal funding doesn't go to providing abortion, right? Wrong. Here's Jessica Arons, Director of the Women's Health and Rights Program at American Progress.
- It effectively bans coverage for most abortions from all public and private health plans in the Exchange: In addition to prohibiting direct government funding for abortion, it also prohibits public money from being spent on any plan that covers abortion even if paid for entirely with private premiums. Therefore, no plan that covers abortion services can operate in the Exchange unless its subscribers can afford to pay 100% of their premiums with no assistance from government "affordability credits." As the vast majority of Americans in the Exchange will need to use some of these credits, it is highly unlikely any plan will want to offer abortion coverage (unless they decide to use it as a convenient proxy to discriminate against low- and moderate-income Americans who tend to have more health care needs and incur higher costs).
2. It includes only extremely narrow exceptions: Plans in the Exchange can only cover abortions in the case of rape or incest or "where a woman suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the woman in danger of death." Given insurance companies’ dexterity in denying claims, we can predict what they’ll do with that language. Cases that are excluded: where the health but not the life of the woman is threatened by the pregnancy, severe fetal abnormalities, mental illness or anguish that will lead to suicide or self-harm, and the numerous other reasons women need to have an abortion.
3. It allows for a useless abortion "rider": Stupak and his allies claim his Amendment doesn’t ban abortion from the Exchange because it allows plans to offer and women to purchase extra, stand-alone insurance known as a rider to cover abortion services. Hopefully the irony of this is immediately apparent: Stupak wants women to plan for a completely unexpected event.
4. It allows for discrimination against abortion providers: Previously, the health care bill included an evenhanded provision that prohibited discrimination against any health care provider or facility "because of its willingness or unwillingness to provide, pay for, provide coverage of, or refer for abortions." Now, it only protects those who are unwilling to provide such services.
Once again, just like in the pre-Roe days, the wealthy will have access to abortion, those who can't scrape several hundred dollars together won't. Because of how the exchange is structured, most of people covered through it will be receiving credits or subsidies. Therefore, most of the participants will not have access to a legal medical procedure. Additionally, the reality, as Arons says, is that the insurers participating in the exchange won't offer it at all, and the question remains whether they'll continue to offer it for women in employer-based programs outside the exchange, or whether it would just be easier for administrative and overhead purposes to stop covering it at all. Right now, nearly 90 percent of private, employer-based plans cover abortion services. This legislation could result in many of those plans dropping it, to make administration of plans simpler and more cost-effective. We know how critical the bottom line is to them.
And take another look at those exclusions: "where the health but not the life of the woman is threatened by the pregnancy, severe fetal abnormalities, mental illness or anguish that will lead to suicide or self-harm, and the numerous other reasons women need to have an abortion." Even planned pregnancies are regularly terminated--legally--because of the health of the mother or severe fetal abnormalities. Forcing women to carry these pregnancies to term is dangerous and cruel. Forcing low- and moderate-income women to have to make hard financial decisions to try to come up with the money for the procedure is cruel. It's also diametrically opposed to the very principles of healthcare reform. This legislation is supposed to be freeing Americans from having to make horrible financial choices between basic necessities and medical care.
Consider this real-life example:
By broadly writing in that insurers can chose whether or not to cover "abortion services," pro-life amendments don't just affect their intended victims -- women seeking a way out of an unwanted or medically harmful pregnancy. They also affect another group of victims -- women whose pregnancies have already ended but have not yet miscarried.
I'm one of those women, and this past Halloween I had what the hospital officially termed an "abortion."
I had learned the day before that the baby I thought was nearly 12 weeks old had no heartbeat, and had actually died at 8 weeks. I was given three options: wait for a miscarriage to occur on its own, something I was told my body had no intention of doing anytime soon, take medication that would expel the fetus, passing it in my own home (classified a "chemical abortion") or come in for a D&C to remove the fetal materials.
As much as I struggled with the sudden realization that the pregnancy was over, I also found myself trying to decide financially what I was willing to do. A chemical abortion would cost $40, but I would be alone, bleeding, and it could still be incomplete and I would require a D&C anyway, since my pregnancy was so advanced. Surgery would be quick, total, and under controlled circumstances, but would likely be our full maxed insurance amount of $1500. And of course, there was the free option of waiting for my body to finally realize I wasn't pregnant, but after 4 weeks the risk of infection was steadily climbing, increasing my chances of future miscarriage, infertility, or even death. With a toddler at home, and still nursing hopes for extending our family some day, this was not an option.
I chose the quick and total route of the D&C, despite the costs, prioritizing my health and the health of possible future children. I was lucky, and could afford to make that choice, because currently, my insurance cannot chose to refuse to cover what the hospital as termed an abortion.
This is the most expansive restriction on access to abortion Congress has passed. It goes well beyond Hyde, which has never been codified and which only governs federal, public plans. It's particularly galling that it comes under the umbrella of healthcare "reform."
Remember the promises? Reform was about expanding choices, not allowing government to come between you and your doctor, no one will lose their coverage, and if you like your current plan you get to keep it. Apparently being female is a preexisting condition that exempts us from the promises, too.