This weekend on NPR, insurance company executives confirmed to NPR health reporter Julie Rovner what the pro-choice community has been saying since the Stupak amendment was added to the House Health reform bill.
In short, the amendment will lead to a virtual elimination of insurance coverage for abortion care, in turn leading to what one analyst calls "devastating outcomes" for some women.
As Rovner reports:
Backers of controversial abortion language added to the House health
overhaul bill last week say it merely continues longstanding policy
that bans federal funding of the procedure. But opponents say it could
have much more far-reaching consequences on access to abortion,
particularly in the private insurance market. The
ultimate impact of the House abortion amendment could be to change
abortion from being a procedure routinely covered by most private
insurance plans to a procedure routinely excluded — even in cases of
The Stupak amendment has two parts with numerous ramifications.
The first part would write into permanent law the so-called Hyde
Amendment, which for three decades has been renewed annually to forbid
direct federal funding for abortions except in certain specific cases —
currently rape, incest and to save the life of the pregnant woman.
of the Hyde language means if there is a government-run public option
available in the new health program, it won’t be able to provide
abortion as a covered benefit," reports Rovner.
But she notes, "the dispute is over the second
part of the amendment, [which would] bar health insurance plans in the new health
insurance marketplaces the bill would create — known as exchanges —
from offering abortion as a benefit to people who are receiving federal
subsidies to pay for their coverage."
Stupak and his supporters claim the fix is easy:
"I can go to the exchange as a private
individual and purchase a plan in the exchange that has abortion
coverage in it because I did not receive any affordability credits," he
said in an interview.
And as NPR notes:
The 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
But, Rovner goes on to report that "most insurance experts say that’s not likely to happen."
really think it would be impractical," says Robert Laszewski, a health
insurance industry consultant. Several health insurance companies
contacted for this story declined to comment, citing the sensitivity of
the subject matter.
Why? Because insurance companies are, as we all know, nothing if not profit maximizers, and asking them to create "boutique policies" for unplanned events at a time when the main objective is to reduce costs will not be tenable. Making the procurement of insurance coverage for abortion care virtually impossible is the unstated goal of the United States Conference of Catholic Bishops and the C-Street fundamentalists trying to impose their view of a Christian world order on Americans.
And Laszewski tells NPR this is precisely what will happen. 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.
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."
"If more plans don’t have it than have it," says Laszewski, "then that becomes the standard of competition and everything else is the exception."
It’s about volume and profit margin, plain and simple.
Rovner also spoke to Sara
Rosenbaum, a health lawyer and professor at George Washington
University, who agreed with Laszewski that "it is 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
So-called abortion riders also are a figment of the far right spin machinery desperately trying to make its efforts to eviscerate women’s fundamental rights seem relatively innocuous and rational.
Stupak, for example, also helpfully suggests that women could use their own money to buy a separate
policy that just covers abortion.
But in real life, this also is not feasible. (Hard when you have to live in the real world, isn’t it?)
According to Laurie Rubiner, Vice President of Public Policy and Advocacy for Planned Parenthood of America, in the five states that already ban private insurance
from covering abortion — Missouri, Idaho,
Kentucky, Oklahoma and North Dakota — no such riders exist.
"We haven’t been able to
find any kind of separate abortion rider, and it doesn’t surprise us
because there’s no market for it. Why is that? Because no woman plans
to have a catastrophic pregnancy, or an unintended or unplanned
pregnancy. Therefore, she doesn’t think about buying coverage
separately for abortion. And since there’s no market for it, the
product doesn’t exist."
As a result, according to both insurance consultant Laszewski and health lawyer
Rosenbaum, the House abortion amendment could dramatically reduce
the availability of insurance coverage.
Rosenbaum says this situation could become what would be a financial catastrophe for women who encounter problems later in pregnancy and do not have insurance coverage.
consequence," says Rosenbaum, "…is to exclude from the insurance system a
procedure–[and] depending on the circumstances under which it’s needed [this could be] an
incredibly costly procedure — and even when it’s not life threatening,
[it may] leave a woman and her family with thousands of dollars in unpaid bills."