Abortion is the most common medical procedure. Abortion is health care. One third of all women in their lifetime will have an abortion. These are longstanding statistics from the highly regarded (even by its adversaaries) Guttmacher Institute which has done studies and statistics on reproductive care issues.
This is worth repeating. Abortion is THE most common medical procedure. Abortion is healthcare. One third 1/3rd of ALL women will an abortion at some point in their lifetime. When women don't talk about it anymore. While abortion is legal it has still been stigmatized.
Before I go on let me say that I have been involved in abortion rights for a couple of decades in leadership roles. This analysis is not just mine from reading the language and knowing the issue but concurs with the other choice groups.
It is enough to make the right to an abortion into a right in name only for most women. Just as in the pre Voting Rights/Civil rights era, blacks had the legal right to vote but they were totally unable to access that right. Effectively meaning they had no rights at all.
So let’s see how much harm the Nelson amendment does. Let's see how deep the knife goes.
So this bill will deprive women of much needed care. The only group who will LOSE care. And why are women being asked to sacrifice once more for everybody else as though women aren’t actually more than half of everybody else.
The Nelson amendment in its impact is almost as devastating in terms of its access to abortion as the Stupak amendment was. And not just for a few women but for tens of millions of women
Provisions
There must be one plan in the exchange that does not have abortion.
No mandate as in the Capps amendment for a plan with abortion.
The conscience clause provision only protects those who refuse to provide service, not to those who do provide service.
Two checks must be written separately. The money for abortion must not only be kept segregated by the insurance companies but by any employer in the exchanges.
If there is an abortion then this money must cover the cost of the abortion....it can't cost more than the premium collected.
States may vote to opt out ...even before the exchanges go into effect.
The opt out provisions for states will indeed happen. Only 17 states provide Medicaid funded abortions now. Of those only 4 -NY, MD, HA, WA do so under any kind of legislative approval, ie under their under rules. They can maintain coverage legally...but will they be able to maintain it in reality if insurance companies may not provide it in their state? The others only provide abortion coverage under court order based on their state constitutions. Who knows what this says about their legislatures?
The vast number of state legislatures are anti choice. Given the numbers of states that opt out there is great likelihood that insurance companies will not offer abortion coverage at all.
Even without states opting out the financing restrictions and the way they highlight and stigmaize abortion mays it very likely that, just like with Stupak, they will just drop abortion coverage in their template.
The separate accounting track is a separate funding track. If you are in a plan that has abortion, then you write 2 checks. One for the premium and the other for abortion coverage. Even if you are a single male, 2 checks. How long so you think he stays in that plan and how long will that plan keep offering abortion coverage. So let's say that the coverage is gotten by the head of the household. This stops being the woman's chice but becomes the choice of the man of the house. The Supreme Court upheld lots of restrictions, but the one they fervidly struck down was the spousal consent one. Well, here we see its resurgence.
Let me further point out that the amendment does not mandate that even in opt out state that there shoud be coverage for rape, incest and the life of the mother. They could opt out without providing even those minimal exceptions.
Even in states that don’t opt out we have serious problems even if there are plans with abortion coverage. Because of the financing rules there is no exception for the consequences of pregancies with dangerous health consequenes for the pregnant women.
The funding rules say that the actual cost of an abortion must be paid for by the segregated premium amount. One that is just like the abortion rider provision in Stupak...stigmatizing. Second it would never cover the abortions that are very expensive....ones like late term one involving, hydrocephaly( fetus has an enlarged head and will die) anencephaly ( no brain) or other dangerous health conditions like worsening maternal diabetes that won't kill her instantly but later. They cost 5 figures or more. No way can premium segreagation add up to that number for a patient.
Of course there is no health of the mother exception at all. The amendment says that the premiums paid for abortion coverage must be enough to pay for the value of the abortion. There is therefore no exception for late term, horrendous conditions like hydrocephaly, anencephaly, dangerous diabetic conditions or other dangerous maternal conditions. After all the woman is not in immediate danger of death..She needs to be at deaths door.
The Federal Health Benefits plan, which does not have health of the mother exceptions since in 2002 George Bush along with a Republican controlled congress extended the Hyde amendment to the FEHBP, such incredibly expensive and sad procedures have indeed had aborion coverage denied to them. Women who sadly had to teminate wanted pregnancies for health reasons found that the OPM ...refused to make the insurance companies pay for such life saving abortions
The amendment does mandate that there be at least one plan with no abortion coverage, unlike the Capps amendment though it does not require that there be a plan with abortion coverage. So the likelihood of abortion coverage withering away is pretty high. It also provides legal "conscience clause " protections for thsoe refusing to provide abortion, not those providing abortion
The payment options are onerous and stigmatizing. Not a plan in the South, Southwest or the middle of the country, even if the states don’t opt out, will offer a plan with an abortion when you have to pay 2 separate premiums to get abortion coverage.
As I said earlier...women lose health care under this amendment and under the health care bill if it’s enacted. Actually the most common and frequent care they get.
Once more women are being told to sacrfice themselves in the service of others. Well we are the others we are being asked to sacrifice for.