As you have probably read by now, the Senate introduced its version of the health care bill yesterday. As expected, it’s good and bad — it includes a public option, but leaves a lot of people out in the cold, and opens up the healthcare debate to an other four years (at least) of what FDL aptly calls “partisan football” (and I would recommend reading their take on the bill — it’s the most comprehensive and critical I’ve seen). 31 million more people, though, would gain health care coverage, and there would be expansions of Medicaid and CHIP.
The good news out of the Senate bill is that it ditches the Stupak amendment language and goes back to a compromise based on the Hyde amendment. Of course, women’s rights advocates can only be so happy with Hyde-based language, since Hyde is a horrible amendment, but the chances of overturning it within the context of health care reform are slim to none; the best we can do is maintain the status quo, get health care reform passed, and then dig in on Hyde (something that reproductive justice groups like SisterSong have been doing for years, without the full, necessary support of mainstream women’s rights organizations).
Harry Reid’s health care bill goes back to the Capps compromise in the House — it basically says that federal dollars won’t be spent on abortion, but at least one plan within the federal health insurance exchange has to cover it. In other words, it keeps the current law.
This is crucial if pro-choicers want to see any sort of victory in the final bill. Assuming this version of the bill passes — and that’s a big assumption with anti-choice democrats in the Senate — the abortion language will have to be hashed out in conference committee. That’s the only way that the Stupak amendment is going to be removed. If anti-choice Dems push for similar language in the Senate bill, we’re pretty much sunk.
Stupak has been framed by the mainstream media as only cutting off abortion coverage to some women — generally code for low-income women who don’t have private health insurance. In fact, low-income women who rely on programs like Medicaid for their health care already don’t have access to abortion, and haven’t in several decades thanks to the Hyde Amendment (some state programs, however, will cover abortion care). What the Stupak amendment does is block funds not only from federally-funded health care programs, but from private programs as well. While it doesn’t outlaw private insurance companies from covering abortion, it does block them from offering abortion coverage to people participating in the health care exchange; those numbers are expected to be fairly large, creating an incentive for companies to cut abortion coverage over time. Or, as Bryan Beutler puts it in summarizing a new study by the George Washington University School of Public Health and Health Services, “though the immediate impact of the Stupak amendment will be limited to the millions of women initially insured through a new insurance exchange, over time, as the exchanges grow, the insurance industry will scale down their abortion coverage options until they offer none at all.” He continues:
Furthermore the study finds that the supposed fallback option for impacted women–a “rider” policy that provides supplemental coverage for abortions only–may not even be allowed under the terms of the law. “In our view, the terms and impact of the Amendment will work to defeat the development of a supplemental coverage market for medically indicated abortions. In any supplemental coverage arrangement, it is essential that the supplemental coverage be administered in conjunction with basic coverage. This intertwined administration approach is barred under Stupak/Pitts because of the prohibition against financial comingling.”
The authors also note that though the direct impact of the Stupak amendment on women who receive insurance from their employers will be initially minimal, the provision’s tentacles could nonetheless reach into the employer-provided insurance market, too, “further driv[ing] the industry to shift away from current abortion coverage norms and toward product designs that meet exchange and Hyde Amendment requirements.”
Nothing but a lot of bad.
Time to start putting pressure on your senators.