States Rights Enacted with Manager’s Amendment

A "compromise" has been reached within the health care debate, and once more women’s reproductive health has been given the short end of the stick.

The newly coined "Manager’s Amendment" has inserted the idea of states rights into abortion access for all women, allowing individual states to opt out of any coverage seen to go "beyond Hyde."
Wonk Room has a good write up on the results for women:

The new managers amendment
to the merged Senate bill incorporates Sen. Bob Casey’s (D-PA) language
strengthening the segregation of private and public funds and
increasing federal support for adoptions, with a new provision that
would allow states “to prohibit abortion coverage in qualified health
plans offered through an Exchange in such State if such State enacts a
law to provide for such prohibition” (page 38 of the amendment).


In other words, states can opt-out of abortion coverage that goes
beyond the Hyde amendment. A state may also repeal the prohibition and
allow plans in the exchange to offer abortion coverage, so long as
those procedures are financed with private premiums.

In states that don’t prohibit abortion coverage within the exchange,
federal dollars can only be used to pay for abortions when the
pregnancy threatens the life of the mother or results from rape or
incest; private premiums must be used to pay for any other type of
abortion, including those for health reasons. Each exchange will also
have to offer at least one plan that does not offer abortion.

The managers amendment also gives state Commissions of Insurance the
ability to audit insurers to ensure compliance with the segregation of
funds in states where abortion is available, increases the Adoption Tax
Credit and federal support for adoption.

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  • mark2

    It’s worse than that.  The actuarial section is where the really problematic stuff is.  It forces health plans to lie about the cost of abortion coverage by ignoring any cost-savings that come from pre/post-natal care and delivery.  This amount will be required by law to be at least a dollar a month.


    This is a tax on women and a fraud perpetrated on the country.  By ignoring the cost-savings, it unfairly presents abortion coverage as far more expensive than it actually is.  This is no different than focusing on the harms caused by cutting someone with a scalpel while ignoring any benefits from surgery.


    So women now get a Hobson’s choice.  They can live in a state that completely opts out of coverage, meaning that coverage will essentially be totally unavailable.  Or they can live a state that provides some limited coverage, but only if they pay an inflated and unreal price through additional bureaucratic coverage.  The manager’s amendment is a double barrier in the way of women’s access to healthcare.


    This is disgusting.  Nelson wants to ban all abortions for all women so we can’t be surprised.  The real culrpit is Olympia Snowe.  She could have stopped this once she saw that the Dems were going to get to 60 without her but on the backs of women’s rights. 

  • wendy-norris

    Mark, would you share some links to the actuarial tables you refer to?

    I’d like to dig into that material and explore your concerns.


  • mark2

    There aren’t even tables, the equation is written directly into the bill.  In the manager’s amendment, 1303(b)(2)(D)(ii) defines how the fee will be calculated.


    ‘‘(ii) CONSIDERATIONS.—In making such estimate, the issuer—
    (I) may take into account the impact on overall costs of the inclusion of such coverage, but may not take into account any cost reduction estimated to result from such services, including prenatal care, delivery, or ostnatal care;
    (II) shall estimate such costs as if such coverage were included for the
    entire population covered; and

    (III) may not estimate such a cost at less than $1 per enrollee, per month.


    So basically, insurers can only take into account costs but not savings, which means that the fee for the rider will be artificially high – of course the insurance companies will keep the windfall. This is so typical of pro-life arguments; a pathological need to hide the truth from people and use fake numbers to make their point.  There is absolutely no justification for not including cost savings in the calculation except that the reality of the situation is unsavory to pro-lifers.


    There’s a reason why 87% of private plans offer abortion coverage.  It makes little sense to deny this coverage to women who want to terminate a pregnancy – after all, the costs of prenatal care and childbirth are far higher in almost every case.  This is not why I support reproductive rights but that’s just how it is.  Pro-lifers don’t like the fact that a market-based solution, so intrinsic to many of their other arguments, does not lead to the outcome they want, so they lie about the numbers.


    Now women are going to be forced to pay an artifically high amount for coverage based on phony numbers and the insurance companies are going to make a huge profit off of it.  This sucks.

  • crowepps

    Now women are going to be forced to pay an artifically high amount for coverage based on phony numbers and the insurance companies are going to make a huge profit off of it.  This sucks.

    It’s pretty obvious to anybody who’s actually paying attention that this bill was written to benefit the insurance companies and not the people who need health care.  By using abortion as a distraction, we have ended up with a ‘plan’ by which people will be required to buy insurance and penalized if they do not, there won’t be any competition to keep rates down from a government option, and the insurance companies will continue to be in charge of rationing care through their ‘claim denial department’.


    At this point, the entire bill looks like a huge failure to me, particularly when it is compared to the single-payer system used in other first world countries.  Of course, we should have expected that the insurance companies would get what they paid for when they bought our representatives.

  • john0874

    I agree with your conclusions and will eagerly look forward to your next acai berry updates.

  • caryben

    Thanks for taking the time to discuss this, I feel strongly about it and love learning more on this topic. It is extremely helpful for me.
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