(PRESS RELEASE) The Center for Reproductive Rights released a new television and online advertisement today calling on pro-choice constituents to contact their senators and demand they not ban abortion coverage that millions of American women already have.
"The promise of healthcare reform is expanded coverage and affordability, eliminating denials of coverage for pre-existing conditions, and a new basic package of essential benefits," said Center for Reproductive Rights President Nancy Northup. "Yet some in Congress are attempting to use the reform bill as a vehicle for banning insurance coverage for abortion services, coverage that millions of women have today. But healthcare reform is not an abortion bill. This attempt to roll back the clock on women's health and rights cannot be tolerated."
D.J. Feldman, a federal employee denied insurance coverage after a termination of a anencephalic fetus, said the denial of coverage surprised and shocked her: "That's when I learned just how punishing, invasive, and painful federal policy is when it comes to women's lives. A decision that should have been left between me and my doctor was made instead by politicians."
On November 7, the House of Representatives voted 240 -to-194 to approve an amendment offered by Rep. Bart Stupak (D.-Mich.) and other representatives to the healthcare reform package. The amendment was sold as a measure that merely maintains current law prohibiting the use of federal funds to pay for abortion. But the Stupak ban reaches beyond those restrictions and would in effect prohibit millions of women from using their own money to buy private health insurance that covers abortion.
Currently, a majority of private insurers offer abortion coverage. Under the Stupak-Pitts abortion ban, women would not be covered for abortions in the new health insurance market despite spending their own money on premiums. And women who opt into the more affordable public option would be banned from getting coverage for abortion services, even if their own money is used to buy their insurance coverage. With Stupak-Pitts, it would be far harder — and highly unlikely given market incentives — for private insurance companies to offer abortion coverage for plans in the health reform marketplace.
The ad will run on cable networks in the Washington, DC, market and on prominent Internet news sites starting Tuesday. The ad was also launched online as part of the Center's campaign at www.NoAbortionBan.org, which also includes a repository of legal and research information on the impact of healthcare reform on abortion services overage.
The script and documentation of "No Joke" are as follows:
A woman walks into a doctor’s office and says: Doc, my back is killing me, does my insurance cover a breast reduction? The Doctor says, “Yes it does.”
See CareFirst (Blue Cross Blue Shield) http://www.carefirst.com/providers/BlueLink/bl_md_2001_october.htm Section Non-Cosmetic Reduction Mammoplasty is Considered Medically Necessary See Cigna http://www.cigna.com/healthinfo/tf2235.html
|A man walks into his doctor’s office and says: Doc, I’ve got trouble breathing out of this side of my nose. Does my insurance cover a nose job? The doctor says: “Yes, it does.”||See Aetna http://www.aetna.com/cpb/medical/data/1_99/0031.html, https://members.kaiserpermanente.org/kpweb/healthency.do?hwid=tf6224|
|A woman walks into her doctor’s office and says: “Doc, I’m 11 weeks pregnant – my baby has anencephaly, which means parts of her skull and brain are literally missing. It’s fatal. Does my insurance cover an abortion? The doctor says: “No it does not.”||
On November 7, 2009, the Senate voted to pass H.R. 3962 the Affordable Health Care for America Act. The bill contains abortion-related language, the Stupak Amendment, which prohibits any coverage of abortion in the public option and anyone receiving a federal subsidy from purchasing a health insurance plan that includes abortion. (http://documents.nytimes.com/the-stupak-amendment#p=1)
The bill would result in current federal restrictions against using federal money to pay for abortions being extended into the private market. See news reports -- http://www.washingtonpost.com/wp-dyn/content/article/2009/11/09/AR20091…, http://www.npr.org/templates/story/story.php?storyId=120234224)
Under current restrictions, women enrolled in Medicaid, federal employees and their dependents, military personnel and their dependents, women served by the Indian Health Service, and Peace Corps volunteers are barred from having insurance coverage for abortion in cases other than life endangerment, rape, or incest. As such, abortions in the case of fetal anomalies such as anencephaly are not covered. (http://www.guttmacher.org/pubs/gpr/11/3/gpr110306.html, http://www.pbs.org/wgbh/pages/frontline/clinic/wars/faqs.html, http://www.medicalnewstoday.com/articles/29398.php, http://writ.news.findlaw.com/hamilton/20091112.html)
|Anencephaly is fatal||
According to the American Congress of Obstetricians and Gynecologists, anencephaly is a type of neural tube defect that occurs when the fetus’s head and brain do not develop normally. (http://www.acog.org/publications/patient_education/bp164.cfm)
According to the CDC Foundation, anencephaly is fatal. (http://www.cdcfoundation.org/healththreats/birthdefects.aspx)
Don’t let Congress ban abortion coverage millions already have.
In the House bill, all individuals with incomes up to 400% of the federal poverty level ($88,000 for a family of four) would receive subsidies to pay for health insurance. Anyone receiving federal assistance is prohibited from purchasing a plan with abortion coverage, even though they are paying part of the premium with their own money. (http://www.washingtonpost.com/wp-dyn/content/article/2009/11/14/AR20091…, http://www.latimes.com/features/health/la-na-health-abortion8-2009nov08…
According to the Congressional Budget Office, 21 million people will participate in the Health Exchange and 18 million of them will receive federal assistance. (http://www.google.com/hostednews/ap/article/ALeqM5ig2n-N48bvgGAWA-wHlMP…, http://www.usatoday.com/news/washington/2009-11-11-abortion_N.htm)
Because the majority of people participating in the Exchange will receive federal subsidies, private insurers will likely cater to the market forces and simply opt not to cover abortion services at all. (http://www.npr.org/templates/story/story.php?storyId=120406487)
The Health Exchange will be available to people without health insurance and to those who purchase their own health insurance and to people who are insured by their small business employers during the first two years that the health care reform plan is in effect. In 2015, Congress will have the option of opening the Exchange to larger employees as well. See H.R. 3962, at § 100(3)(B).
According to the Associated Press, while women who are on Medicaid and already restricted from abortion coverage and women who have private plans through their own or their husbands’ large employers will not be affected by the Stupak amendment, prime candidates for the federally-subsidized plans in the Exchange are women who are not receiving health coverage through an employer, but purchasing their insurance through the individual market. These women may be self-employed, unemployed, underemployed, divorced women who formerly were insured through their husbands\' employers, and women who work in small businesses whose owners decide to seek more affordable coverage through the new exchange. (http://news.google.com/news/url?sa=t&,ct2=us%2F0_0_s_0_2_aa&,usg=…)
According to Guttmacher Institute and Kaiser Permanente, the majority of private insurance plans offer abortion coverage. As such, women who are currently purchasing their insurance through the individual market and decide to transition to a more affordable health plan in the exchange would likely have to forgo the abortion benefits they currently have. (http://www.guttmacher.org/media/inthenews/2009/07/22/index.html)
Under the Stupak Amendment, women would be required to purchase “riders” for abortion coverage, but it is inherently irrational to ask women to plan for an unplanned pregnancy or medically complicated pregnancy. Even if women were inclined to purchase a rider, it seems likely that most health care providers in the Exchange will not offer them. Currently five states have laws that require a “rider” option. See Idaho Code §§ 41-2142, 41-2210A, 41-3439, 41-3924 (life endangerment), Ky. Rev. Stat. § 304.5-160, Mo. Rev. Stat. § 376.805, N.D. Cent. Code § 14-02.3-03, Okla. Stat. § 1-741.2 (life endangerment, rape, or incest).
However, according to the Kaiser Health News, no private insurer in two of the states, North Dakota and Oklahoma, offers the supplemental abortion coverage. The other three states do not track the existence of the riders, so it is not clear whether the policies are being offered. Our own analysis, at NoAbortionBan.org, further shows that riders are largely unavailable. (http://www.kaiserhealthnews.org/Stories/2009/November/10/abortion-expla…)
Under the amendment, the availability of coverage, according to prominent insurance experts, is likely to be very restricted due to market mechanisms. As National Public Radio reported: “…Stupak's amendment does say that health insurers can offer plans with abortion coverage to people who are paying the full premiums themselves, as long as they offer identical plans without abortion coverage to people who are getting subsidies. But most insurance experts say that's not likely to happen.
"I really think it would be impractical," says Robert Laszewski, a health insurance industry consultant. …Laszewski says the problem is that by all estimates, the vast majority of people who will be shopping in the new exchanges will be getting subsidies, so they won\'t be allowed to get abortion coverage. Thus, if a health insurer did offer a separate plan with abortion coverage, it would only be available to a small universe of buyers, and it simply wouldn\'t make much business sense.
“It's not an ideological issue, it's not about abortion or not abortion," Laszewski says. "It's about what is administratively simpler, easier to administer. It just adds a level of complexity they will likely avoid.”
Sara Rosenbaum, a health lawyer and professor at George Washington University, agrees that it's impractical to expect health insurance plans to cover abortion in the exchanges, even for people paying the full premiums without federal help. “If you speak to insurers in the industry, they will tell you that they simply can\'t operate under these circumstances," Rosenbaum says. "They need to be able to offer standard products that get administered in a standard way for everybody."” Julie Rovner, “Health Bill Abortion Clause May Derail Insurance,” National Public Radio, Nov. 14, 2009, http://www.npr.org/templates/story/story.php?storyId=120406487