We finally know where President Obama comes down on the abortion issue in the House and the Senate bills. He prefers the language of the Nelson amendment over the language of the Stupak amendment. Both amendments are still regressive, a major step back for women, and all for the votes of conservative Democrats enabled by the White House and Democratic leadership.
"There needs to be some more work before we get to the point where we're not changing the status quo. And that's the goal," Obama told me in November.
So, does the Senate language come closer to what the president wants than the House language?
Gibbs told me this morning: "Yes."
Once again, here's why NARAL and Planned Parenthood opposes the regressive Nelson amendment, and a study from GWU that explains how the Nelson amendment could affect nearly all health insurance plans (not just in the exchange, but outside of it) by 2019 by having the effect of standardizing lack of abortion coverage in health insurance plans. For reference, today, nearly 80% of all health insurance plans cover elective abortion procedures. That would likely disappear under the Nelson amendment, thanks to the Democratic leadership who were desperate enough to pass this health bill that they allowed Stupak to offer his amendment to roll back women's reproductive rights, and then allowed Nelson to offer his amendment over his filibuster threat.
NARAL:
It is outrageous that, two weeks after pro-choice Americans came to Capitol Hill united against the egregious Stupak-Pitts amendment, the Senate has succumbed to including further anti-choice language in its bill. While the Senate bill does not include the Stupak-Pitts provision, this new language is unacceptable. It is inexplicable that a bill seeking to expand health coverage for Americans would impose such great administrative burdens on women who purchase abortion coverage and plans that offer it...
[T]he language regarding abortion coverage comes at too high a price for reproductive health. Thus, we must oppose this new Nelson language. And NARAL Pro-Choice America withholds support from the overall health-reform legislation until we assess the totality of provisions in the final bill that comes out of a conference committee between the House and Senate.
Planned Parenthood:
"Planned Parenthood strongly opposes the new abortion language offered by Senator Ben Nelson in the manager's amendment. Last week, the Senate rejected harsh restrictions on abortion coverage, and it is a sad day when women's health is traded away for one vote.
Here's Newsweek magazine on the Nelson abortion language.
It is this so-called "two-check" provision that has greatly frustrated pro-choice groups. They are nervous that consumers (particularly those who are not women of childbearing age) will find the extra fee burdensome while giving them no benefit, and decide to switch to another plan without abortion coverage. If enough consumers made these switches, insurers could begin to drop their abortion coverage altogether. "It unfairly treats abortion as a separate, stigmatized benefit," says Nancy Keenan, president of NARAL Pro-Choice America. "Requiring these insurance plans to process hundreds of additional transactions, I think that runs the risk of creating a significant disincentive for plans to offer abortion services in their coverage." An analysis of the language by Sara Rosenbaum, a professor in the George Washington University's department of health policy, says that it will "have a significant impact on the ability or willingness of insures to offer ... medically indicated abortions."
One Senate aide involved in the negation says they knew that pro-choice groups would not be pleased with the deal being struck. "Health-insurance reform was always meant to be about increasing health choices, not taking them away," says Alex Glass, communications director for Patty Murray, one of the five senators involved in the abortion compromise. "Is this the language we wanted? No, but it stopped Stupak and kept health reform moving forward without rolling back women's health-care options."
Pro-choice lobbying organizations have been much more pointed in their criticism of the language, generally opposing or withholding support from the Senate bill because of it. NARAL has withheld its support from the Senate bill, while Planned Parenthood and the National Organization of Women have all come out in opposition to the Senate bill despite numerous provisions in support of women's health, including Sen. Barbara Mikulski’s amendment to expand preventative care and screenings for women at little to no cost for them. The Senate bill would also eliminate gender rating, an insurance industry practice that generally results in women paying higher premiums.
Here's also an important diary by debcoop in which she covers in great detail the highly regressive nature of the Nelson amendment on women's reproductive rights. And by way of mcjoan, here's that GWU study by Sara Rosenbaum which I referenced to earlier:
Taken together, the provisions of the amendment can be expected to have a significant impact on the ability or willingness of insurance issuers to offer Exchange products that cover a full range of medically indicated abortions. Furthermore, as with insurance laws generally, and for the reasons stated in our earlier analysis [blogged here], the amendment could be anticipated to have considerable spillover effects. This is because companies that issue insurance products (or administered products in the case of sales to self-insured plans) obviously desire to sell these products in as many markets as possible. If one purchaser market places significant restrictions on one or more aspects of product design, it is likely that sellers will attempt to design their products to a common denominator, so that the product can be sold across all markets in which the company desires to do business. This is particularly true with modern health insurance coverage products, where the concern is not only the coverage but the provider network through which coverage will be obtained. Negotiating the elements of such a product is extremely difficult, and it is just as difficult to have to explain to providers that some of their patients will be insured for certain medical procedures while others will not....
Payments would have to be strictly segregated, subject to state insurance commissioner oversight and adherence to federal segregation requirements. For several reasons this provision could be expected to chill issuers' willingness to sell products that cover a range of medically indicated abortions. They would have to comply with complex audit standards and more importantly, they would have to collect an additional fee from each member of their plan, a step that could be expected to encounter broad resistance. (It is also not clear what the consequences would be for plan members who do not make the payment or whether non-payment would place them in arrears). The more logical response would be not to sell products that cover abortion services.
The Nelson amendment represents a discriminatory financial burden on needed abortion coverage for women, which is kind of funny in a sad way because in the Democratic platform, it states that on page 50:
The Democratic Party strongly and unequivocally supports Roe v. Wade and a woman's right to choose a safe and legal abortion, regardless of ability to pay, and we oppose any and all efforts to weaken or undermine that right.
By allowing the Nelson amendment in, it basically codifies the Hyde Amendment as a "reasonable" compromise as the law of the land regarding women's reproductive rights. It goes against what President Obama campaigned on against the Hyde amendment. Here is his prior position on the Hyde amendment:
RHRealityCheck.org
Does Sen. Obama support the Hyde amendment? Under what circumstances does he believe that Medicaid should cover abortions (all pregnancies, life- or health-threatening pregnancies, pregnancies that are a result of rape or incest, extreme fetal malformation)?
Obama does not support the Hyde amendment. He believes that the federal government should not use its dollars to intrude on a poor woman's decision whether to carry to term or to terminate her pregnancy and selectively withhold benefits because she seeks to exercise her right of reproductive choice in a manner the government disfavors.
And President Obama, in an earlier interview with Katie Couric, said that he'd be okay if the public plan excluded abortion coverage due to the long-standing tradition of the Hyde amendment:
Katie Couric: Do you favor a government option that would cover abortions?
President Obama: What I think is important, at this stage, is not trying to micromanage what benefits are covered. Because I think we're still trying to get a framework. And my main focus is making sure that people have the options of high quality care at the lowest possible price.
As you know, I'm pro choice. But I think we also have a tradition of, in this town, historically, of not financing abortions as part of government funded health care. Rather than wade into that issue at this point, I think that it's appropriate for us to figure out how to just deliver on the cost savings, and not get distracted by the abortion debate at this station.
This is in direct conflict with the statements that he'd made on the campaign trail in support of the public plan, and including women's reproductive rights as a part of the public plan:
"In my mind, reproductive care is essential care, it is basic care . . it is at the center and the heart of the plan that I propose. Essentially . . we're going to set up a public plan that all persons and all women can access if they don't have health insurance. It will be a plan that will provide all essential services, including reproductive services." (7/17/07)
How things change.....and we now have a President that's comfortable with restrictions on women's reproductive rights, and not fighting to repeal the Hyde amendment or standing up against the Nelson amendment. This Democratic Party sold out women's reproductive rights just to get conservative Democrats' votes for a health insurance reform bill that delivers 30 million captive customers to private insurers.
UPDATE:
For those asking for proof that the President prefers Nelson's abortion compromise over the Stupak amendment, here it is straight from the Washington Post where the White House staff worked with Senator Nelson, and Barbara Boxer worked with other Senators on the Nelson abortion compromise:
At one end of the majority leader's office, Ben Nelson (D-Neb.), the antiabortion senator whose support was crucial to health-care legislation, huddled with White House staff in a conference room. At the other end, Sens. Barbara Boxer (D-Calif.) and Patty Murray (D-Wash.), the chamber's leading advocates of abortion rights, hunkered as far from Nelson as possible, in the office of Reid's chief of staff.
Shuttling between the two parties Friday afternoon and evening were Majority Leader Harry M. Reid (D-Nev.) and Sen. Charles E. Schumer (D-N.Y.). Desperately trying to find a compromise, Schumer put his head in his hands early Friday afternoon. "What are we going to do?" he asked Reid.
But by 10:30 p.m. Friday, a handshake deal sealed a hard-won compromise over abortion. Within minutes senators were on the phone with Obama, who was flying aboard Air Force One, having just forged his compromise with world leaders on global warming, according to senators and aides who participated in the negotiations. "We did it, Mr. President," Reid told Obama.