Abortion Funding Fundamentals Under Health Reform


Abortion has become a popular sideshow
in the three-ring circus of the debate over health care reform. In
particular, many questions about abortion funding have arisen—some
genuine and some distorted.

Opponents and supporters of abortion rights agreed early on, in theory,
to maintain the status quo with “abortion neutral” health care
legislation. The idea was that health care reform is not the
appropriate place to continue the fight over abortion and neither side
should attempt to use health care reform as a vehicle to further expand
or restrict access to abortion.

In pursuit of this objective, Rep. Lois Capps (D-CA) introduced an amendment
in the House Energy and Commerce Committee that attempted to strike a
balance and preserve the status quo on abortion funding. This proposal
was adopted on
July 30, 2009. On the Senate side, Finance Committee Chairman Max
Baucus (D-MT) has proposed a bill that includes abortion funding
provisions that closely mirror the Capps amendment.

Yet even finding agreement on the current state of play can be a
challenge for an issue as controversial as abortion. This chart
explains the current law on abortion funding and shows how the House
and Senate bills would maintain or change the status quo.

 

Current law Capps Amendment to House health care reform bill Senate health care reform bill
The Hyde Amendment
The Hyde Amendment prohibits federal Medicaid and Medicare money from being spent on most types of abortion, including pregnancies that threaten the woman’s health or involve fetal anomalies. Federal money can only be used to pay for an abortion when the pregnancy threatens the life of the woman or results from rape or incest. The Hyde Amendment restrictions would apply to all insurance plans that participate in the health insurance exchange, whether those plans are operated by private insurers or by the government’s “public option.” In other words, no federal funding, including affordability credits or other subsidies, would be used to pay for abortions beyond what is currently allowed. Private premiums would be segregated from public funds and only the private premiums could pay for abortion services beyond those allowed by the Hyde Amendment. The Hyde Amendment restrictions would apply to all insurance plans that participate in the health insurance exchange, whether those plans are operated by private insurers or member-run co-ops. In other words, no federal funding, including affordability credits or other subsidies, would be used to pay for abortions beyond what is currently allowed. Private premiums would be segregated from public funds and only private premiums could pay for abortion services beyond those allowed by the Hyde Amendment.
Other government programs
Laws similar to the Hyde Amendment that restrict coverage of abortion services also apply to military employees and their dependents, federal employee health plans, members of the Peace Corps, women in federal prisons and detention centers, and Native Americans who receive health care through the Indian Health Services. Current restrictions on federal spending for abortion services would not change. Current restrictions on federal spending for abortion services would not change.
States
States have the option to use their own money to pay for abortion services beyond what is permitted under the Hyde Amendment, and 17 states currently do so. Federal money subsidizes these state Medicaid programs even though they cover abortion. Federal money would subsidize plans that cover abortion—just like they currently do for state Medicaid plans and employer plans—but no public money would be used to pay for abortion services not allowed by the Hyde Amendment. Government money would only be used to help pay for the other medical services covered by those plans. Federal money would subsidize plans that cover abortion—just like they currently do for state Medicaid plans and employer plans—but no public money would be used to pay for abortion services not allowed by the Hyde Amendment. Government money would only be used to help pay for the other medical services covered by those plans.
Private insurance
Private insurance companies are allowed to decide whether to cover abortion services, and 87 percent of typical employment plans currently provide such coverage. The federal government subsidizes these plans through an employer tax credit, even if the plans include abortion. Each plan in the exchange could decide whether to cover abortion services beyond those allowed by the Hyde Amendment, provided that at least one plan in each market area offers such services and one plan does not. This provision goes well beyond current law to guarantee that consumers have the option to purchase a plan that suits their medical needs and their values. No abortion services—even those allowed by the Hyde Amendment for cases that threaten the woman’s life or result from rape or incest—can be mandated as part of a minimum benefits package. Each plan in the exchange could decide whether to cover abortion services beyond those allowed by the Hyde Amendment, provided that at least one plan in each market area offers such services and one plan does not. This provision goes well beyond current law to guarantee that consumers have the option to purchase a plan that suits their medical needs and their values. No abortion services—even those allowed by the Hyde Amendment for cases that threaten the woman’s life or result from rape or incest—can be mandated as part of a minimum benefits package.

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  • dena88

    I think that they should be funded, it costs the government a whole lot more every year on welfare and food stamps for certain children who are born into underprivelidged society in situations of which the mother would have chosen to abort the pregnancy but can’t afford it, while those born into money can afford an abortion and better yet can afford to raise thie child if it is born….

    http://www.therakebackmafia.com

  • sexstudent

    I don’t understand how the government can choose to not pay for a legal procedure. Medicine is medicine and a legal procedure is a legal procedure. There should be no “values” attached to a medical procedure because it is a legal medical procedure. Providing medical care has nothing to do with personal values, it is providing medical care.

    "Religions are all alike- founded upon fables and mythologies." Thomas Jefferson

  • jeornom

    Private premiums would be segregated from public funds and only the private premiums could pay for abortion services beyond those allowed by the Hyde Amendment.

     

    • The government collects the private premiums.
    • The private premiums are mandatory for those who participate in the public option (no conscientious objectors).
    • Abortion providers are paid by the US Treasury.

     

    Saying that the "private premium" is different from federal funding is dishonest – at least have the rectitude to call it what it is. The federal government will be funding abortion.

  • jodi-jacobson

    "federal government collects the private premiums…"?

    for one thing, the majority of people enrolled in private plans would not be subsidized and would be paying *as per usual* into plans either individually or through their employers.

  • jessica-arons

    Hi jeornom.  Let me clarify a few things.

     

    1) The only plan the government will run in the exchange is the public option, and that is the only case in which the government will be "collecting" premiums.  But no one is forced to participate in the public option; everyone will be able to choose any plan in the exchange that they want.  All the other insurers in the exchange are private companies and they will collect the private premiums from their consumers directly.   

     

    2) Every market area will be required to offer at least one plan that does not cover abortion.  Thus, anyone who has a conscience-based objection will have an option to buy into a plan that does not cover abortion. This is a guaranteed option that does not currently exist today.

     

    3) It is not yet clear whether there will be a public option.  It is part of the three House bills and the Senate Health Education Labor & Pensions (HELP) Committee bill, but it is not part of the Senate Finance Committee bill.  Efforts to amend the Finance Committee bill to include a public option failed just yesterday.

     

    4) Even if there is a public option, it will operate more or less like a private company, despite the fact that its name includes the word "public."  Amtrak is a hybrid public-private entity, but despite the government’s involvement, I don’t think anyone feels that purchasing a train ticket is the same as paying taxes.  The proceeds are revenues that go back into operating the business, not into Treasury coffers that provide for the general welfare.  The "public option" health insurance plan would operate much in the same way.

     

    I hope this clears up any confusion.

  • douglasjohnson

    Douglas Johnson, legislative director for the National Right to Life Committee (NRLC), dropping in here with a few observations on the contribution by Jessica Arons.

     

    Ms. Arons talks about "the three-ring circus of the debate over health care reform." Well, before you can get into the tent to see that three-ring circus, you have to get past the booths of the carnival barkers. Their pitches are glib but invariably deceptive. If you stand and watch for awhile, you can generally figure out the con. Let’s take a closer look at this one.

     

    Brazenness is a key element of many attempted cons, and so it is here, as illustrated, for example, by the constant repetition of the claim that the Capps Amendment would preserve the "status quo."  The reality: The Capps Amendment is an attempt to smuggle into law language that would result in (1) direct funding of elective abortion by a federal agency, and (2) direct use of federal funds to pay premiums for private insurance plans that would cover elective abortion. Both of these outcomes would be sharp breaks from decades of federal policy, breaks that have been long sought by pro-abortion advocacy groups. Under the panoply of current federal laws — to which Jessica Arons refers, but describes in misleading terms — neither of these things is permitted in any current federally funded health program.

     

    The Capps Amendment is a phony compromise. In terms of draftsmanship it is an artful construct — crafted to look something like a true Hyde Amendment restriction to the uninitiated reader, but in legal and policy effect, incorporating an inversion of the Hyde Amendment. Ms. Arons’ piece here is another attempt to market this political scam. Her pitch is a mish-mash of half-truths and myths, taped together with non sequiturs.

     

    Allow me to discuss six myths about the Capps Amendment that are perpetrated in Ms. Arons’ piece.

     

    MYTH NO. 1:  Ms. Arons implied that the Capps Amendment represents a compromise between "opponents and supporters of abortion rights." The truth: The Capps Amendment is not a compromise between the two sides. It is a phony compromise, actually written by House Energy and Commerce Committee Chairman Henry Waxman (D-Ca.) and his veteran staff, and then delegated to Rep. Lois Capps (D-Ca.). Both Waxman and Capps have impeccable career-long records as opponents of all pro-life legislation. The amendment language was blessed by lobbyists for such pro-abortion groups as Planned Parenthood and Third Way, and vigorously opposed by all bona fide pro-life groups. In Waxman’s committee on July 30, the amendment was adopted with 30 votes, only one of which came from a Democrat with a largely pro-life voting record — the other 29 came from pro-abortion lawmakers. There were 28 votes against the amendment.

     

    So, the Capps Amendment really was a "compromise" between Waxman, who is the congressman from Hollywood, and Planned Parenthood.

     

    The Democratic leadership in the U.S. House of Representatives originally intended that very little time would pass between the unveiling of the Capps phony compromise and the House floor vote on the health care bill, H.R. 3200. It did not work out that way. Under weeks of sustained critical scrutiny, the true effects of the Capps Amendment have become evident to more and more observers, including many Democratic lawmakers who do not wish to vote for government-funded abortion or government-funded insurance for abortion.

     

    MYTH NO. 2:  Ms. Arons implied that the Hyde Amendment and similar laws only ban direct federal funding of abortion procedures. The truth: The laws that currently cover major federal health programs do prohibit direct federal funding of abortion procedures, but that is not all they do. They also prohibit federal funds from subsidizing health plans or trust funds from which payments for abortions are made. (The exceptions to both prohibitions are abortions to prevent the death of the mother, and in most programs, for cases of rape or incest.) Ms. Arons carefully omits reference to the components of the current laws that prohibit subsidies for abortion-covering plans, because to acknowledge this key component of current law would mess up her attempt to portray the Capps Amendment as "status quo" legislation. So, let’s look at a couple of actual examples.

     

     

    The Federal Employees Health Benefits (FEHB) Program:  About 260 private insurance plans participate in the FEHB program, but none of them cover elective abortions, because these plans are federally subsidized, and the law says that no federal funds may "pay for an abortion, or the administrative expenses in connection with any health plan under the Federal employees health benefits program which provides any benefits or coverage for abortions."

     

     

     

    The Hyde Amendment, which reads in pertinent part: Sec. 507. (a) None of the funds appropriated in this Act, and none of the funds in any trust fund to which funds are appropriated in this Act, shall be expended for any abortion. (b) None of the funds appropriated in this Act, and none of the funds in any trust fund to which funds are appropriated in this Act, shall be expended for health benefits coverage that includes coverage of abortion. (c) The term ‘health benefits coverage’ means the package of services covered by a managed care provider or organization pursuant to a contract or other arrangement.

     

     

    MYTH NO. 3:  Ms. Arons wrote that under the Capps Amendment, "no public money would be used to pay for abortion services not allowed by the Hyde Amendment. Government money would only be used to help pay for the other medical services covered by those plans." The truth: H.R. 3200 would create a nationwide federal health insurance program, the "public plan." The Capps Amendment explicitly authorizes the public plan to pay for all elective abortions. Barack Obama has promised Planned Parenthood that his public plan WILL pay for abortions (as PolitiFact.com recently checked out and confirmed, here.)

     

    You can watch Obama make the promise here.

     

    So, this part is really quite simple: The "public plan," if created, would be a program within the Department of Health and Human Services (DHHS), part of the federal Executive Branch, headed by the Secretary of Health and Human Services. Under H.R. 3200 [Section 222(b), page 119], money will be collected from several sources, including payments by enrollees, and deposited in a U.S. Treasury account devoted to the public plan. All of these funds in that Treasury account will be "public money" and "government money," just as surely as the money that the Treasury gets from you via the IRS.

     

    Thus, under the Capps Amendment, through the public plan, the DHHS would be engaged in directly funding elective abortions, with federal funds (which are the only kind of funds that DHHS can spend). This would be a complete break with the Hyde Amendment policy.

     

    As for the attempt to market this as a continuation of the "status quo," see my opening comment regarding the brazen component in many con games. The claim that a federal agency would be using private funds to pay for abortions is an impossibility, a political hoax.

     

    I wonder if Jessica Arons would embrace the notion that federal agencies other than DHHS — say, the CIA, or the Pentagon — also could fund projects with "private funds" drawn from accounts in the U.S. Treasury?

     

    [The National Right to Life Committee (NRLC) has issued a legal memorandum proving that all of the funds that would be expended by the "public plan," and also all of the funds that would flow to the premium-subsidy program, would be in fact "federal funds," both as a matter of law, and in the usage of those terms by and about federal agencies across the board. The memorandum contains links to primary documents from the Congressional Budget Office, the General Accounting Office, and the nonpartisan Congressional Research Service. It is here.]

     

    MYTH NO. 4:  Ms. Arons implied that allowing federal subsidies to pay for part of the premiums of private plans that cover elective abortions would be like the "option" that 17 states currently employ to fund abortions with state money for Medicaid-eligible women. The truth: This argument is an effort at misdirection, mixing apples and oranges. Each of us live under two sovereigns — the federal government, and a state government (unless one lives in a federal enclave). As I have quoted above, under the Hyde Amendment, no federal Medicaid funds may flow to any trust fund that pays any abortions (except to save the life of the mother, or in cases of rape or incest). Moreover, the states are prohibited from spending even their state-generated Medicaid matching funds for abortions.

     

    But of course, the Hyde Amendment does not prevent a state from setting up its own completely separate program to pay for abortions for people who are Medicaid-eligible, or for anybody else, for that matter. This really has nothing to do with the subject of the current debate, which is whether elective abortion should be part of the proposed FEDERAL public insurance plan, and whether private insurance plans that cover elective abortion should receive FEDERAL subsidies. Citing these STATE Medicaid policies is another device by pro-abortion forces to distract attention from the sharp departure that the Capps Amendment represents from existing FEDERAL policy regarding subsidies for abortion.

     

    Nothing in the NRLC-backed anti-abortion-subsidy amendments to the health care bills — the Stupak-Pitts Amendment to the House bill, or the Hatch Amendment to the Senate bills — would prevent states from setting up their own programs to pay for abortions or abortion insurance.

     

    MYTH NO. 5:  Ms. Arons wrote, "87 percent of typical employment plans currently provide such coverage [abortion services]." The truth: This claim is based on a 2002 Guttmacher survey that arrived at the 87% figure by counting any insurer that chose to respond that it covered abortion in a "typical" plan (whatever that means), even though "some of the insurers reporting that abortion was covered narrowly interpreted this to mean when a pregnancy threatens a woman’s health" (p. 76). However, Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, the insurance industry’s trade association, told CQ Today (July 15, 2009), "Most insurers offer plans that include this coverage but most employers choose not to offer it as part of their benefits package." Moreover, during her confirmation proceedings to be secretary of Health and Human Services, Kathleen Sebelius told the Senate, in writing: “Most private plans do not cover abortion services except in limited instances, but do cover family planning, and Congress has limited the Federal Employee Health Benefit Plan to covering abortion services only in cases of rape or incest, or when the life of the mother is in danger.”

     

    MYTH NO. 6:  Ms. Arons wrote that the Capps Amendment "goes well beyond current law to guarantee that consumers have the option to purchase a plan" that does not cover abortion. The truth: Read the fine print. The "guarantee" is boobytrapped. It is tied to the Hyde Amendment, which is a temporary law that applies only to funding that flows through the annual Health and Human Services appropriations bill, and that expires every September 30. The first year that the Hyde Amendment is not renewed — for example, because a pro-abortion President threatens to veto the DHHS funding bill unless it is dropped — that is the end of the Capps "guarantee" that at least one abortion-free private plan will be available. And, of course, a lapse in the Hyde Amendment also would result in a resumption of federal funding of abortion on demand in Medicaid, a program in which the federal government was paying for 300,000 elective abortions annually before the Hyde Amendment was first passed in 1976. Keep in mind that Barack Obama has always opposed the Hyde Amendment.

     

    In recent days, more than 30 House Democrats have written to Speaker Pelosi to point out that the Capps Amendment just won’t do. The House Democratic leadership now has some people working on gluing on some additional trim and accessories so that they can try to peddle Capps II as a new model. But under the hood, it will still be the same old clunker.

     

    Douglas Johnson

    Legislative Director

    National Right to Life Committee

    Washington, D.C.

    Legfederal — at — aol, dot, com

    202-626-8820

     

    More than you want to know about the abortion-related components of the current health care bills here: http://www.nrlc.org/ahc

     

    Videos here: http://stoptheabortionagenda.com