Why The Stupak Amendment Is A Monumental Setback

This article was originally published by ThinkProgress and is republished here with permission from the author and the Center for American Progress Action Fund.

If you thought that just because abortion is a constitutional right and
part of basic reproductive health care it would be available in the
reformed health insurance market known as the Exchange, think again.
The Stupak Amendment, passed Saturday night by the House of Representatives after a compromise deal fell apart, potentially goes farther than any other federal law to restrict women’s access to abortion.

The claim that it only bars federal funding for abortions is simply false. Here’s what the Stupak Amendment does:

1. It effectively bans coverage for most abortions from all public and private health plans in the Exchange:
In addition to prohibiting direct government funding for abortion, it
also prohibits public money from being spent on any plan that covers
abortion even if paid for entirely with private premiums. Therefore, no
plan that covers abortion services can operate in the Exchange unless
its subscribers can afford to pay 100% of their premiums with no
assistance from government “affordability credits.” As the vast
majority of Americans in the Exchange will need to use some of these
credits, it is highly unlikely any plan will want to offer abortion
coverage (unless they decide to use it as a convenient proxy to discriminate against low- and moderate-income Americans who tend to have more health care needs and incur higher costs).

2. It includes only extremely narrow exceptions:
Plans in the Exchange can only cover abortions in the case of rape or
incest or “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.” Given insurance companies’
dexterity in denying claims, we can predict what they’ll do with that
language. Cases that are excluded: where the health but not the life of
the woman is threatened by the pregnancy, severe fetal abnormalities,
mental illness or anguish that will lead to suicide or self-harm, and
the numerous other reasons women need to have an abortion.

3. It allows for a useless abortion “rider”: Stupak
and his allies claim his Amendment doesn’t ban abortion from the
Exchange because it allows plans to offer and women to purchase extra,
stand-alone insurance known as a rider to cover abortion services.
Hopefully the irony of this is immediately apparent: Stupak wants women
to plan for a completely unexpected event.

4. It allows for discrimination against abortion providers:
Previously, the health care bill included an evenhanded provision that
prohibited discrimination against any health care provider or facility
“because of its willingness or unwillingness to provide, pay for,
provide coverage of, or refer for abortions.” Now, it only protects
those who are unwilling to provide such services.

One in three women will have an abortion in their lifetime. Eighty-seven percent of employer plans offer abortion coverage.
None of that will matter if the Senate takes its cues from the House.
In every other way, this bill will expand access to health care. But
for millions of women, they are about to lose coverage they currently
have and often need.

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  • douglasjohnson

    Today (Nov. 9), PolitiFact.com reviewed a November 7 claim by Rep. Nita Lowey (D-NY), a pro-abortion leader in the U.S. House, that the Stupak-Pitts Amendment "puts new restrictions on women’s access to abortion coverage in the private health insurance market even when they would pay premiums with their own money," and concluded that Lowey’s claim is "FALSE."  Read it here.


    Regarding the Stupak-Pitts Amendment, President Obama said today (November 9) that "there needs to be some more work before we get to the point where we’re not changing the status quo," and that he did not want the health care bill to be "an abortion bill."


    But the only thing that will prevent the health care bill from being "an abortion bill" is precisely retention of the Stupak-Pitts Amendment. The adoption of the amendment in the House by a 46-vote margin — including the yes votes on fully one-fourth of Democrats — demonstrates, among other things, the growing recognition of the phoniness of your side’s claim (which Obama repeated again today) that your goal is to preserve the ‘status quo’ on abortion policy. In reality, the White House, top Democratic congressional leaders, and the abortion lobby have been working hard to create a national federal government health plan that would fund abortion on demand, just as Obama promised Planned Parenthood in 2007.


    In an e-mail alert distributed on Sunday, November 8, the Planned Parenthood Action Fund said, "President Obama campaigned on a promise to put reproductive health care at the center of his reform plan." The alert urged Planned Parenthood supporters to send Obama emails saying, "Now it’s time for you to make good on that commitment."


    On that occasion, Obama said: "Well, look, in my mind reproductive care is essential care. It is basic care. And so it is at the center and at the heart of the plan that I propose. . . . Essentially, what we’re doing is to say that 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’ll be a plan that will provide all essential services, including reproductive services."


    An archive of NRLC letters to Congress and other documents regarding the abortion-related components of the health care legislation are posted here.


    Douglas Johnson

    Legislative Director

    National Right to Life Committee

    Washington, D.C.

    Legfederal // at // aol-dot-com


  • eternalskeptic

    This piece from NPR sets the record straight:


  • jodi-jacobson

    The NPR story was wrong on several counts.



  • ahunt

    I’m still struggling to understand all of this, Jodi.
    What I’m getting is that no one knows exactly how Stupak plays out, because it depends on the "interpretation" of the amendment. This is making me nuts. I really need to understand Stupak before I go off. Is there a comprehensive plain english analysis?

  • jodi-jacobson

    You are not alone in struggling, because the implication of this law is extraordinarily broad and far-reaching and as with most such laws, is in fact open to interpretation.

    However, I think Jessica’s piece does a good job of articulating some concerns, while this piece based on an in-depth analysis by Planned Parenthood goes even further and further explains things with examples.  Moreover, there is another piece on the site today in which Iowa Senator Tom Harkin (Democrat) elaborates on how far-reaching this could be.

    The purpose of the insurance exchange and the public option is to give both uninsured people and under-insured people, as well as people who are small business owners, self-employed, etc a place to go to get insurance coverage at a good cost, and for those making under $88,000 per year for a family of four, a government subsidy.

    The Capps amendment said, if an insurance company offers a policy in the insurance exchange (at a reduced/affordable rate), the money that would cover any and all abortions had to come solely from the private premium portion of that pool of money.

    What the Stupak Amendment does is to say: Any insurance company participating in the exchange, whether it is recieving a government subsidy or not, is now barred from providing insurance coverage of abortion even if you, or I or person X is buying that policy solely with our own money.  Among many things this does is to discriminate strongly against poorer women who are more likely to rely on the exchange as well as increasingly numbers of women, as employers increasingly shift away from providing health care coverage as a core benefit.

    This is just one of the problems outlined in the PPFA memo and elsewhere…..

    We will continue to disaggregate this and publish articles on it, but I can assure the best legal and medical minds in this community are at work trying to suss out all the implications even as I write.

    Best, Jodi

  • grayduck

    …[wanting an abortion is] a completely unexpected event.


    So are you saying that other medical procedures are expected? How could I have foreseen the need for the lumbar puncture that I received today?



  • jodi-jacobson

    but you are covered for that.

  • grayduck

    Jodi Jacobson, Senior Political Editor on November 11, 2009 – 9:44pm: "but you are covered for that."


    But if women should not plan for unexpected events, and all medical procedures are unexpected, then why should women have health insurance? Are you saying that women should be excluded from the national health plan altogether?



  • grayduck

    "…the Stupak Amendment…prohibits public money from being spent on any plan that covers abortion even if paid for entirely with private premiums."


    Not true. From Section 265 of the bill passed by the House: "…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…"




    "As the vast majority of Americans in the Exchange will need to use
    some of these credits, it is highly unlikely any plan will want to
    offer abortion coverage…"


    How does that assertion negate the claim that the Amendment "…only bars federal funding for abortions?" If plans in the Exchange do offer abortions, would you admit that you are wrong? If so, why"


    "Plans in the Exchange can only cover abortions in the case of rape or incest or ‘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.’"


    What wording in the amendment are you using as authority for that legal opinion?



  • tonys

    Abortion is NOT healthcare unless the mother’s physical life is in danger.

    I am very sorry that you have a life inside you that you don’t want. If you want to kill your unborn son or daughter, please pay for it yourself.   Don’t force me to take part in it.

    "It is poverty to decide that a child must die so that you may live as you wish"  Mother Teresa