Will his anti-abortion amendment save health care reform, or wreck it?
By Anne Stanton
U.S. Representative Bart Stupak is in the hot seat. Forty-one Democrats have signed a letter saying they wont approve a final bill for affordable health care reform if it contains his abortion amendment.
Yet it was Rep. Stupaks amendment that allowed the health reform bill to squeak through the house with a 215-210 vote on November 7. If the amendment is taken out of the final compromise bill, 64 Democrats say they wont vote for it.
Could abortion be the issue that kills affordable health care reform?
Stupak, who represents the 1st Congressional District, including Petoskey, the Straits and the Upper Peninsula, said in an interview last week that people need to read his amendment, which he co-authored with Joe Pitts (R-PA), before they believe whats being claimed. It makes no changes to current law, he said.
Like the historic 1976 Hyde Amendment, Stupaks legislation would ban federal .dollars from being used to pay for abortions (except in the case of rape, incest and danger to the life of the mother). Because of the Hyde Amendment, federal workers, including those in the military, women on disability, those receiving care from Indian Health Insurance, and poor women on Medicaid, are barred from receiving federal assistance or insurance coverage for abortions. Most states also ban Medicaid coverage for abortions, effectively leaving the legal option of abortion out of reach for many poor women, who cant pay the $300 to $700 fee.
GOING TOO FAR?
Planned Parenthood says Stupaks amendment goes even beyond the Hyde amendment because it will indirectly affect people who arent receiving any federal subsidies.
This is the way it works. Under the health reform plan, a family of four earning up to $88,000, certain small businesses, and the self-employed can buy their insurance policies through an exchange. This virtual marketplace of insurance policies is intended for people having difficulty getting insurance; the exchange provides either a private insurance policy or a public government plan for those who qualify.
Stupaks amendment says participating insurance companies cannot include abortion coverage in their policies to anyone receiving a federal subsidy, unless the pregnancy was the result of incest or rape, or if the pregnancy endangers a womans life. (Exceptions do not include a fetus with severe or fatal birth defects, or if the pregnancy will severely damage a womans health.)
Planned Parenthood claims the policy could effectively ban abortion coverage for anyone taking part on the exchange, not just the lower middle class who receive federal subsidies. Thats because the vast majority of people in the exchange will receive a subsidy to help pay for the premiums. Insurance companies will likely take the path of least resistance and offer just one plan, said Tait Sye, spokesman for Planned Parenthood.
Lets say Im subsidized, and youre not. The insurance company wants as many enrollees as possible. So theyll open it up to people with subsidies, and that requires their policy provide no abortion coverage. A second planwith abortion coveragewould be less appealing, overall, because a much smaller fraction of people wont have subsidies.
The way insurance works, it would be hard to imagine that you will offer a plan for three people without subsidies, as opposed to a plan for 100 people with subsidies. Whats clear, is that those people receiving subsidies will impact those who dont, she said.
In terms of the amendment providing all people in the Exchange the option to buy an abortion rider with their own money. Not likely, because no one plans an unexpected pregnancy, and there will be few takers.
Planned Parenthood says that 87 percent of all health care plans cover abortion. But if 18 million people join the exchange, as expected, the insurance companies may drop abortion from policies, perhaps even outside the exchange, simply because its cheaper and easier to offer a standardized policy.
Stupak said in a cell phone interview with Express that Planned Parenthoods objections are not valid. Once the exchange goes into business, once this bill passes, every insurance policy in the U.S. will be eligible for the exchange if they meet a minimum benefit package.
And there are currently more than 200 policies available, such as those offered by Blue Cross/Blue Shield, Cigna and Aetna, he said.
The exchange is really just a database, which will allow comparative shopping, Stupak said. So the fact that no insurance company will offer two versions of a plan, thats not right.
What does PolitiFact say about this specific point? Theres plenty of room for debate.
Heres the rest of the interview with Rep. Bart Stupak:
Express: More than 18,000 Americans die every year for the sole fact they cant afford to pay for private health care insurance, according to a study entitled Care without coverage: Too little, too late. If abortion is the key issue stopping health reform, will you feel you have traded off the lives of the unborn for the lives of the born?
Stupak: My amendment assured it would pass! It would never have passed, the health care bill never would have made it through the House, even with the Capps Amendment (an earlier amendment that banned federally funded abortions, but which Stupak said didnt go far enough). Even with the Capps Amendment, it would have been soundly rejected.
Sixteen thousand people die a year because they dont have health insurance. Is there an ethical imperative to pass health care reform? Absolutely. As elected officials we have to make those decisions. Let me reiterate. If the Stupak Amendment was not in the bill, health care would not have passed in the House. Go to PolitiFact.com. It states that Bart Stupak might have just saved health care reform. Anyone who knows what went on, knows that without right-to-life Democrats, they wouldnt have passed health care.
Express: But now 41 representatives signed a letter saying they wont vote on it with your amendment.
Stupak: First of all, members write these letters all the time. Secondly, lets see what the conference committee wording is before we make these wild claims (the role of the conference committee is to devise a final bill acceptable to both the House and Senate. The Senate has not passed its version; the public option, not abortion, is the sticking point for senators).
They are talking about whether my language is in there, but we dont even have a bill. They are talking about a bill that doesnt exist. Thats not a very credible argument.
Everyone says theyre going to do this, going to do that. We all need to take a deep breath. What did the president say? Keep current law. We should keep current law. The Stupak language is no more than current law. No public funding for abortions, no public funding for insurance policies that cover abortions. But if you want abortion coverage, you can get it even if you get public funding for insurance. You can buy a supplemental abortion policy with your own money.
Express: Mennonites, Amish and conscientious objectors oppose war of any kind because it involves killing people, the same objections you hold toward abortion. But their tax money must still go toward war. Are your religious convictions more important than theirs?
Stupak: Theres a lawthe Hyde Amendmentthat federal spending should not pay for abortion. There is not a law that exempts people from paying for war. There isnt a law like that. When I send in my taxes, and you pay your taxes, you dont get to tell the government you dont believe in the war. I didnt believe in the Iraq war, but I couldnt tell people not to pay their taxes.
Under federal benefits, until two years ago, we never paid for mental health services. We didnt always pay for glasses. There are certain benefits that, as the employer, we are willing to pay for. Its not discriminatory. Its that people dont think abortions should be covered. Its not just Catholics, not just Republicans. There are Episcopalians, Methodists, Protestants, a wide range of people who believe that life is sacred, and federal funding shouldnt be used to pay for abortions.
Express: Do you feel the facts of your amendment are being misrepresented?
Stupak: By some groups yes.
Express: Does that make you angry?
Stupak: No because I look at PolitiFact, I listen to NPR public radio, and they say those people are wrong. Im happy to show anyone this amendment. All were doing is current law. And if you say you want abortion funding for anyone who wants it, were not going there. Every life has value.
The Stupak-Pitts Amendment
Questions about the Stupak-Pitts amendment? Heres what it says:
(a) IN GENERAL - No funds authorized or appropriated by the Act (or amendment made by this Act) may be used to pay for any abortion or to cover any part of the costs of any health plan that includes coverage of abortion, except in the case 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 unless an abortion is performed, including a life-endangering physical condition caused by or arising from the pregnancy itself, or unless the pregnancy is the result of an act of rape or incest.
(b) OPTION TO PURCHASE SUPPLEMENTAL COVERAGE OR PLAN Nothing in this section shall be construed as prohibiting any nonfederal entity (including an individual or a State or local government) from purchasing separate or supplemental coverage for abortions for which funding is prohibited under this section, or a plan that includes such abortions, so long as-
(1) Such coverage or plan is paid for entirely using funds not authorized or appropriated by this Act; and
(2) Such coverage or plan is not purchased using-
(a) individual premium payments required for an Exchange-participating health benefits pan towards which an affordability credit is applied; or
(b) other nonfederal funds required to receive a federal payment, including States or localitys contribution of Medicaid matching funds.
(c) OPTION TO OFFER SUPPLEMENTAL COVERAGE OR PLAN -
Notwithstanding section 303(b), nothing in this section shall restrict any nonfederal QHBP offering entity from offering separate supplemental coverage for abortions for which funding is prohibited under this section, or a plan that includes such abortions, so long as-
(1) premiums for such separate supplemental coverage or plan are paid for entirely with funds not authorized or appropriated by this Act;
(2) administrative costs and all services offered through such supplemental coverage or plan are paid for using only premiums collected for such coverage or plan; and
(3) any nonfederal QHBP offering entity that offers an Exchange-participating health benefits plan that includes coverage for abortions for which funding is prohibited under this section also offers an Exchange-participating health benefits plan that is identical in every respect except that it does not cover abortions for which funding is prohibited under this section.