Health Care Reform Update: Effort to Restrict Abortion Coverage Fails, Mixed Results on Abstinence Only Funding
The health care reform debate hasn’t been encouraging for reproductive health advocates, but on Wednesday the Senate Finance Committee pushed back against a Republican amendment designed to “doubly triply restrict abortion coverage in the bill,” as Rachel Maddow described it last night.
Republican Olympia Snowe of Maine joined almost all of the Democrats to defeat the amendment 13-10. Sen. Kent Conrad of North Dakota, a Democrat, voted for the restrictions along with the rest of the Republicans. Robert Pear of The New York Times explains the framework of the amendment:
The bill, written by the chairman of the Finance Committee, Senator Max Baucus, Democrat of Montana, says that no tax credits could be used to pay for abortions except as allowed in the latest appropriations for the Department of Health and Human Services — in case of rape or incest or if the life of a pregnant woman was in danger.
Under the bill, some health plans would cover abortion, and some would not. Private insurers that chose to cover abortion would be required to segregate money, taken from private premiums, to cover the procedure.
The amendment, offered Wednesday by Senator Orrin G. Hatch, Republican of Utah, would have gone much further. It said that no money provided under the legislation could be used to pay “any part of the costs of any health plan that includes coverage of abortion,” with a few limited exceptions. Under the proposal, insurers could have offered “a separate supplemental policy” to cover abortions. Such policies would have been financed “solely by supplemental premiums paid by individuals choosing to purchase the policy.”
Once again, Sen. Debbie Stabenow (D-Mich.), who demonstrated last week during a debate about pregnancy coverage that she is a no-nonsense force to be reckoned with, fired back against treating women as second-class citizens. She argued that the amendment goes far beyond existing law, which already prohibits spending federal dollars to pay for abortions for women on Medicaid, and it would restrict access to abortion for all women. Here’s my transcript of the video above:
In fact, with all respect to my friend, as a woman, I find it offensive that in [this amendment], any woman, any family purchasing through the exchange — if they did not receive any tax credit — would be prohibited from having the full range of health care options that they may need covered. This doesn’t just refer to the tax credits. As I read this: “prohibit private insurers operating through the exchange from offering coverage” — this is an unprecedented restriction on people who paid for their own health care insurance.
Then, when we look at the fact that this offers, that people could have a supplemental single-service rider, the assumption that somehow a woman or family would say, “You know, some day we may have an unintended pregnancy, so we’re going to get a separate rider. Or maybe my pregnancy is going to have a crisis — many, many crises — and so we’re going to try to find some other rider.”
In my judgment, I don’t even know how that would work. In the few states that have tried to do that, there’s no evidence that even those kinds of riders are available.
It’s remarkable that discussions about abortion conveniently leave out that it is a legal, medical procedure. Or that one in three women will have had an abortion by age 45. Or that three-fourths of women who obtain an abortion say they cannot afford to have a child. Or — as we saw in the weeks after the murder of Dr. George Tiller, when women stepped forward to reveal their stories — the decision is sometimes heartbreakingly, medically necessary.
We’re not the only ones frustrated by the way abortion has turned into a wedge issue for health care reform.
“In a rational system of medical care, there would be virtually no restrictions on financing abortions,” reads an editorial published in today’s New York Times. ”But abortion is not a rational issue, and opponents have succeeded in broadly denying the use of federal dollars to pay for them, except in the case of pregnancies that result from rape or incest or that endanger a woman’s life.”
“There should be no restrictions on abortion coverage in the exchanges,” the editorial concludes. “Health care reformers should not retreat on this issue, but we recognize that principle is often sacrificed in Congressional bargaining. Democrats who support the compromise must find a way to prevent it from being used later to go after other tax subsidies and thus further deny Americans’ rights to make their own health-care decisions.”
Hatch put forth a second amendment to strengthen existing “conscience clause” laws protecting healthcare workers from performing abortions or other services to which they have moral or ethical objections. It also failed on the same on the same 10-13 margin; Snowe voted with the Democrats, and Conrad with the Republicans.
Funding for Abstinence Only Education
On Tuesday night, the committee approved a comprehensive sex education funding stream, the Personal Responsibility Education for Adulthood Training. That amendment, proposed by Baucus, provides $75 million for states, according to the Sexuality Information and Education Council of the United States (SIECUS), “$50 million of which would be geared to evidence-based, medically accurate, age-appropriate programs to educate adolescents about both abstinence and contraception in order to prevent unintended teen pregnancy and sexually transmitted infections, including HIV/AIDS. The remaining funds would be for innovative programs as well as research and evaluation.”
Snowe joined all Democrats in passing the amendment; the vote was 14–9.
Yet on the same night, the committee voted for an amendment introduced by Hatch to restore federal funding for abstinence-only education — “better known,” said Maddow, “as the best teen pregnancy and STD delivery system politicians have ever devised.”
Democrats Conrad and Blanche Lincoln of Arkansas joined all 10 Republicans on the Finance Committee to vote in favor of adding $50 million-a-year funding for the Title V abstinence-only program to the health care bill, despite the fact that President Obama’s 2010 budget eliminated funding for abstinence-only education programs — because they simply don’t work.
Even Texas got the message. The state that ranks first in spending on sexual abstinence has the third-highest teen birth rate in the country and the highest percentage of teen mothers giving birth more than once. As the Austin American-Statesman reported on Sunday, some school districts are giving up the abstinence-only model and adopting a more comprehensive sex education curriculum, also called “abstinence-plus.”
Both amendments still have to pass the full House and Senate, so it’s anyone guess where the dollars will fall, but SEICUS is optimistic that legislators will wake up and reject the abstinence-only funding.
“This amendment takes a giant step backward by restoring funding for the failed and discredited abstinence-only-until-marriage program for the states,” said William Smith, vice president for public policy at SEICUS. “However, because this program so clearly doesn’t work and half the states don’t even participate, we are confident it will be stripped from the final bill and ask Congressional leaders and the White House to ensure this happens.”