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The George Washington School of Public Health and Health Services has analyzed Stupak-Pitts, and concludes that "the Amendment would produce industry-wide effects, leading to the elimination of health plan coverage for nearly all medically indicated abortions."

Although the Amendment appears to address only plans that receive federal exchange subsidies, even health plans sold to private, large employers that purchase outside the exchange ultimately are likely to be affected, the analysis concludes. These findings are based on an assessment of the extent to which the health benefits services industry adjusts its products over time to conform to the regulatory environment in which it operates.

"Under national health reform, millions of women, including women who are covered by small employers (as employees or spouses or dependents of employees) as well as those who are currently uninsured, will receive their coverage through health insurance exchanges. By barring the sale of subsidized products that cover medically indicated abortions as part of a broader package of benefits, the Amendment can be expected to cause the industry to re-design its offerings in order to avoid violating the legal restrictions on abortion applicable to exchange products that receive subsidies," said Professor Sara Rosenbaum, JD, lead author and Chair of the Department of Health Policy. "The Amendment also can be expected to chill efforts to develop supplemental coverage for medically indicated abortions, because it appears to prohibit the joint administration of both a basic and supplemental product," Rosenbaum noted.

Additionally, "based on past experiences with claim administration decisions involving treatment exclusions," the analysts conclude that insurers are likely to interpret the exclusion broadly, and exclude not just elective abortions, but also medically indicated abortion and "treatments for serious illnesses, injuries, and medical conditions that include an abortion undertaken for health reasons." Insurance administrators, they find, are likely to err on the side of coverage denail in order to avoid sanctions.

The report also includes findings on the "rider" provision of the legislation, the provision that would supposedly allow women to purchase supplemental abortion coverage. From the full analysis [pdf].

The provisions of the legislation, as well as the technical challenges that arise in benefits administration, militate against the creation of a supplemental coverage market. Thus, if the result of national health reform is to move millions of women into a market that operates subject to the exclusion, then it is fair to predict that the entire market for coverage ultimately will be affected as a product tipping point is reached and virtually no supplemental market appears." (p. 14)

Orrin Hatch plans to introduce the Stupak amendment in the Senate. This amendment isn't just a reiteration of Hyde, it's a direct attack on a legal, medical procedure, not to mention the women who might need it.

Originally posted to Daily Kos on Wed Nov 18, 2009 at 07:00 AM PST.

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