Thursday’s bipartisan meeting at the White House (which you can follow live) promises to kick-start what may be the final descent toward healthcare reform. An overview:
Does healthcare reform have a chance? Is bipartisanship a real possibility? David Leonhardt of The New York Times provides some provisional answers.
Igor Volsky over at the Wonk Room brings us up to speed by providing a nice, clear comparison of the House bill, the Senate bill and President Obama’s new proposal.
As far as questions women should be asking about their stake and status in the debate, Lisa Codispoti and Brigette Courtot at the National Women’s Law Center remind us of the “8 Questions” they have been asking all along — and how Obama’s proposal addresses (or fails to address) the issues.
Writing at Raising Women’s Voices, Amy Allina identifies ways in which Obama’s proposal builds on the Senate bill but also notes that it “does not include the changes that Raising Women’s Voices has been urging Congress to make to the restrictive abortion provisions in [the Senate] bill” — namely by eliminating the requirement that policyholders make two separate monthly payments if they want a policy that includes abortion coverage.
Finally, this is politics, and political agendas and expediency can often trump what’s right. Brian Beutler and Christina Bellantoni at Talking Points Memo dissect each party’s strategies, and Ezra Klein at the Washington Post provides a viewer’s guide.
All of this may come down to an arcane Senate procedure known as reconciliation. David M. Herszenhorn at The New York Times offers a primer.
When you feel yourself getting tired of all the red tape, get a pep talk from Ellen Schaffer and Joe Brenner at EQUAL/Center for Policy Analysis, whose PowerPoint — “The Truth About Health Reform: It’s Up to Us” — helps to put priorities in order.
We wanted to share this important notice from SisterSong regarding a Georgia House bill created ostensibly to protect women of color from being targeted by abortion providers. Note the Trust Black Women press conference on Tuesday on the steps of Georgia’s Capitol, mentioned at the end of this bulletin.
For more information about the current anti-abortion billboard campaign in Georgia, visit SPARK Reproductive Justice Now.
* * * * * * *
SisterSong Women of Color Reproductive Justice Collective OPPOSES House Bill 1155 — The Sex and Race Selection Bill. This bill seeks to ban the solicitation and targeting of women of color by abortion providers throughout the state.
This misleading issue of abortions for sex- and race-selection in Georgia means that we have to use facts and science to stand up for women of color without undermining our support for abortion rights or without enforcing racial stereotypes about women of color. Intent on driving a wedge between reproductive justice and racial justice organizations, and pro-choice advocates, the bill reflects the false assumption that abortion providers throughout the state “solicit” women of color.
If implemented, this bill will adversely impact abortion providers by requiring them to prove that they are not targeting women of a certain race or ethnicity. This burden could result in delayed medical services, particularly for women of color. Additionally, this legislation would alter the racketeering laws of the Georgia Code to include abortion providers. This is unacceptable as abortion is legal in the State of Georgia, and the alleged abuses of this medical procedure are unfounded. Such a bill would have a terrible effect on women’s ability to access reproductive health care services throughout the state.
This bill comes on the heels of a controversial billboard campaign that targets Black women in Georgia. The blatantly sexist and racist billboards declare Black children as an endangered species and prey on the conscience of Black women. The mere association between the born and unborn with endangered animals provides a disempowering and dehumanizing message to the Black community, which is completely unacceptable.
The statewide 80-billboard campaign is sponsored by The Endangered Species Project, a collaborative effort between The Radiance Foundation and Georgia’s Operation Outrage. We recognize that the lived experiences of women of color, and Black women specifically, drive how and when women choose abortion, not abortion providers who defend women’s rights. In order to protect the lives of women and families, abortion must remain safe, legal, affordable, and accessible. Any attack on women’s rights is in violation of all of our human rights.
SisterSong will detail the damaging effects of HB 1155 and how the public can advocate for the reproductive justice, reproductive rights, and reproductive health of women of color. Sponsored by SPARK Reproductive Justice NOW, during their Legislate THIS! Action Day, the Trust Black Women Press Conference will take place on Tuesday, February 16, 2010 at 12:00 pm on the steps of Georgia’s Capitol.
OBOS is committed to expanding our audience and in this spirit we’ve asked former board member Moises Russo to translate into Spanish several of our blog entries. We hope to translate more entries in the coming year.
En OBOS estamos comprometidos a expandir nuestra audiencia de lector@s y en este espíritu le hemos solicitado a Moisés Russo, ex-miembro de la Junta de OBOS, que traduzca al español varios de los blogs que tenemos en la página electrónica. Esperamos continuar con dichas traducciones durante este año.
Un juez federal le ha ordenado a la Administración de Alimentos y Comida (FDA) el día lunes que haga la píldora anticonceptiva del día después “Plan B” disponible sin prescripción médica a mujeres jóvenes desde los 17 años de edad.
El juez falló que la agencia había cedido en forma inapropiada a presiones políticas de la administración Bush el 2006 cuando estableció el límite en los 18 años de edad.
La agencia tiene 30 días para cumplir con la orden, en la cual el juez también instó a la agencia a considerar remover todas las restricciones a las ventas de Plan B sin prescripción. El medicamento consiste en dos píldoras que previenen la concepción si son tomadas dentro de las primeras 72 horas luego de una relación sexual.*
Nancy Northup, Presidenta del Centro por los Derechos Reproductivos, el cual demando a la FDA en representación de organizaciones de mujeres e individuos, llamó el fallo del juez “una completa reivindicación del argumento que los defensores de los derechos reproductivos han estado haciendo por muchos años, que en administración Bush era la política, y no la ciencia, la que guiaba las decisiones en temas de salud de las mujeres.
“Plan B” ha estado disponible en los Estados Unidos desde 1999, pero inicialmente solo con prescripción médica. Hubo que esperar hasta el 2006 para que la FDA aprobara las ventas sin prescripción médica a mujeres desde los 18 años de edad, lo cual significa que debe estar en stock detrás del mostrador en las farmacias y que las mujeres deben mostrar un comprobante de su edad. Esto lo hace difícil para que algunas mujeres, incluyendo a inmigrantes sin documentos, puedan obtener las píldoras en forma fácil cuando las necesitan.
En su fallo de 52 páginas, el Juez Edgard R. Korman de la Corte del Distrito Federal en Nueva Cork concluyó que “no hay ningún propósito útil que esté siendo cautelado si se continúa la privación de acceso a Plan B a mujeres de 17 años sin prescripción médica”, y que “tanto los oficiales como personal de la FDA han estado de acuerdo en que mujeres de 17 años pueden usar “Plan B” en forma segura sin prescripción médica”.
Korman dijo que la decisión de la FDA “no fue el resultado de un proceso de toma de decisiones razonado y de buena fe dentro de la agencia”. El juez citó a oficiales de la FDA por comunicarse en forma impropia con oficiales de la Casa Blanca sobre “Plan B” y llenar el panel de expertos a cargo de analizar el medicamento con personas que tienen visiones en contra del aborto. La FDA también ignoró las conclusiones sobre seguridad del medicamento a las que llegó de su propio panel asesor.
En un artículo publicado la semana pasada en el Huffington Post, Northrup resume el bizantino trayecto de la aplicación del estatus de venta sin prescripción a “Plan B”, y describe lo que se conoció durante el juicio:
Meses de testimonios en el caso federal han dejado al descubierto una red de engaños tras bambalinas, repleto de oficiales de alto nivel en la FDA doblegándose a influencias políticas externas, eludiendo las regulaciones de la agencia, para finalmente conspirar para otorgar solamente acceso restringido a “Plan B”.
Testimonios judiciales revelaron que un oficial confesó a uno de sus colegas que tuvo que rechazar la solicitud de “Plan B” por miedo a perder su empleo. Otro le dijo a un colega que el plan era que la agencia pospusiera cualquier decisión sobre el medicamento todo el tiempo que fuera posible y, si se vieran forzados a actuar, aprobar el medicamento con una restricción etaria, todo para “apaciguar a los votantes de la administración [Bush]”.
Susan Wood, la anterior directora de la FDA para asuntos de salud de las mujeres, que renunció el 2005 como protesta a las demoras en aprobar “Plan B”, le dijo al Times ahora hay una nueva oportunidad de “restaurar la integridad científica de la FDA”.
Además: ¿Necesitas información sobre Anticoncepción de emergencia, o si tu farmacia más cercana la tiene en stock? Revisa el “Sitio Web de Anticoncepción de Emergencia”, un recurso independiente, con revisión de pares administrado por la Oficina de Investigación sobre Población de la Universidad de Princeton y por la Asociación de Profesionales en Salud Sexual y Reproductiva.
Tomorrow Massachusetts voters will go to the polls for a special election to fill the seat of the late Ted Kennedy. The incredibly, unexpectedly tight race has implications that reach nationwide.
Whoever wins this seat may cast the deciding vote in the Senate for healthcare – and play a crucial role in other divisive issues down the road. Democratic candidate State Attorney General Martha Coakley will vote in favor of healthcare reform; her Republican rival, State Sen. Scott Brown, has promised to vote against it.
While there are many reasons to be frustrated with healthcare reform, consider these numbers: Without reform, 54 million people or more (depending on who’s guesstimating) won’t have insurance in 2019; under the Senate bill, that number is reduced to 23 million, and under the House bill it’s even lower, at 18 million. And both bills have an employer mandate and subsidies for low-income families.
And there are many smaller points that you may not have noticed in such big bills, such as 100 percent Medicare reimbursement for certified nurse midwives.
If you haven’t been following this race closely, you may be interested in this summary of the media coverage. Coakley has been criticized a la Hillary Clinton — too stern and serious. Let’s agree, though, that she never would have stood a chance had she posed nude for Cosmo way back when, as did Brown.
Via AirForceTimes I learned that the Compassionate Care for Servicewomen Act [S 2904/HR 4386], a bill that would require emergency contraception to be made available at all military health care treatment facilities, was introduced in mid-December by sponsors Al Franken (D-MN) in the Senate and Michael Michaud (D-ME) in the House.
NARAL Pro-Choice America praised the bill, noting the bill’s potential affect on women serving overseas, stating, “Sen. Franken’s bill is based on the principle of fairness: Women in the military serving overseas should be able to access EC the same way women stateside do.”
The blogger at Lettuce Spray called the Senate Committee on Armed Services about the legislation (something she also encourages others to do), and learned that “the committee has not yet scheduled anything for January, and are not scheduled to start any hearings until after January 20th. As soon as a hearing date is set (if at all) it will be posted to their website.”
OBOS co-founder and executive director Judy Norsigian has been in Nashville, TN, for the weekend, and this morning she was a guest on Liberadio(!), Mary Mancini and Freddie O’Connell’s local political radio show.
Topics covered include the history of the organization and the need for its work (including the landmark book and newer initiatives), the PRIM&R conference Judy attended while in town, Senator Kennedy, health care reform, media portrayals of health reform proposals, the Stupak amendment, abortion, age discrimination, social justice and diversity, among others.
The show is archived online at http://tinyurl.com/yhadu9s (you may need to download RealPlayer to listen). Judy’s segment starts at about 1:32 of the 2-hour episode. No transcript is available, but you can get some quick text notes on the segment via Liberadio(!)’s Twitter updates from this morning.
Thanks to Liberadio(!), and to everyone who came out to the OBOS house party last night!
The passage is bittersweet, but finally it’s done … With 6:51 time remaining to vote, Democrats have secured the 218 “yea” votes needed to pass the Affordable Health Care for America Act (HR 3962).
Final tally 220-215; 39 Democrats voted “no.” One Republican — Rep. Joseph Cao, who represents the New Orleans area — voted “yea.”
“Democrats have sought for decades to provide universal health care, but not since the 1965 passage of Medicare and Medicaid has a chamber of Congress approved such a vast expansion of coverage,” reports the Washington Post. “Action now shifts to the Senate, which could spend the rest of the year debating its version of the health-care overhaul. Majority Leader Harry M. Reid (D-Nev.) hopes to bring a measure to the floor before Thanksgiving, but legislation may not reach Obama’s desk before the new year.”
As I watched Democrats congratulate themselves, it was difficult to feel celebratory. Passage of the Stupak amendment — which bars a government-run insurance plan from offering abortion *and* prohibits women who receive government insurance subsidies from purchasing private plans that include abortion coverage — sucked a lot of the energy out of the room.
As Princeton professor Melissa Harris Lacewellsaid on Twitter, “Stupak feels like Prop 8 [which overturned same-sex marriage in California the same night President Obama was elected]. When the ‘win’ is accompanied by legislation that attacks the most marginal it doesn’t feel like a win.”
For a look at how each House member voted, check out this Washington Post graphic. You can sort the list by how much money each member has received in campaign contributions from the health industry and by the percent of people without health insurance in each district . The New York Times does a nice job of showing the geography of the vote (mouseover the states to reveal individual districts).
The House is debating the Stupak amendment limiting access to abortion services — you can watch it on C-SPAN.org, or follow along on the Twitters (hashtag #stupak), where many of us are quoting the representatives for and against. I’m @cmc2
And in case the current House bill’s provisions on abortion are in doubt, read Maggie Mahar’s analysis: “The fact of the matter is that the House bill contains more than two dozen references to abortion and virtually all of them describe how insurers can restrict or deny coverage for the procedure.”
Update: Amendment passed 240-194-1 (Republican Rep. John Shadegg of Arizona cast the lone “present” vote). A surprising number of Democrats – 64 — joined Republicans in passing the amendment. View the roll call here.
Jodi Jacobson just posted a piece at RH Reality Check that begins:
Tonight, with the aide of some 60 Democrats, women’s rights were effectively negated by the US Congress as the House passed the Stupak amendment to HR 3200, the Affordable Health Care Act of 2009.
More in-depth analysis of how we got here is forthcoming. But one thing is clear: The US Conference of Catholic Bishops (USCCB) apparently is running the US government, aided by a cadre of “faith-based advocacy groups,” the House Democratic leadership, the White House and members of the Senate.
Remember, this amendment is not a done deal. It still has to pass Senate and then survive the conference committee, and women’s groups are already mulling action in the weeks to come. But what a sad day it is when the only way to gain health care coverage is to lose a legitimate, legal health care procedure.
Another distressing point: The New York Times reports that only one male lawmaker — Rep. Jerrold Nadler of New York — joined women who spoke against the amendment on the House floor. A correction is in order: My own Congressman here in Chicago, Mike Quigley, also spoke out (cheers!). But that may have been it.
Here, from the Times, are bits of what other lawmakers said during the debate:
Representing the abortion-rights segments of the Democratic membership, Representative Diana DeGette of Colorado called the amendment a “wolf in sheep’s clothing” that would deny women access to care. Representative Lois Capps of California argued that the underlying bill already prohibited federal financing of abortions. The amendment, she said, “Actually restricts coverage of a legal medical procedure.”
“Not one other medical procedure is singled out for rationing” in the larger bill, she said.
Others contended that this amendment would result in women having to go out and buy insurance that would cover such a procedure, a prospect one lawmaker scoffed at, saying a woman does not plan for an unplanned pregnancy.
Representative Nita Lowey, Democrat of New York, called it “a disappointing distraction” from the main event. Representative Barbara Lee, Democrat of California, said the amendment would take women “one step back” toward the dark days of back-alley abortions. Representative Rosa DeLauro, Democrat of Connecticut, said, “We should not be injecting this divisive and polarizing issue into our debate.”
And the full speech by Rep. Jan Schakowsky of Illinois:
This Stupak-Pitts Amendment goes way beyond current law. It says a woman cannot purchase coverage that includes abortion services using her own dollars — even middle-class women using exclusively their own money will be prohibited from purchasing a plan including abortion coverage in every single public or private insurance plan in the new Health Care Exchange.
Her only option is to buy a seperate insurance policy that covers an abortion — a ridiculous and unworkable approach since no woman plans an unplanned pregnancy.
This amendment is a radical departure from current law that will result in million of women losing the coverage they already have. Our bill is about lowering health care costs for millions of women and their families, not for further marginalizing women by forcing them to pay more for their care. This amendment is a disservice and an insult to millions of women throughout the country, and I urge a NO vote on this amendment.
These strong responses ultimately weren’t enough to kill the amendment, but they did serve as a reminder of the urgency of electing more pro-choice women to Congress. Anyone else have points to share?
The House is expected to vote today on a $1.055 trillion health care package that would expand coverage for up to 36 million people — but first there will be a vote on an amendment that severely limits abortion coverage in a new government-run insurance plan and through private insurance that is bought using government subsidies.
After a back-room fight last night, House Speaker Nancy Pelosi agreed to allow the amendment proposed by Rep. Bart Stupak (D-MI). It reads:
The amendment will prohibit federal funds for abortion services in the public option. It also prohibits individuals who receive affordability credits from purchasing a plan that provides elective abortions. However, it allows individuals, both who receive affordability credits and who do not, to separately purchase with their own funds plans that cover elective abortions. It also clarifies that private plans may still offer elective abortions.
If you are reading this on Saturday, stop. Call your representatives and tell them this amendment is unacceptable. Go, now. We’ll wait. [Update: See this list of 11 representatives who are on the fence. These members, in particular, need to hear from you.]
It looks likes the amendment has enough votes to pass may be a close vote, and lawmakers need to know that a health care bill that tosses out a legal medical procedure used by millions of women every year is unacceptable.
The Washington Post’s Ezra Klein writes:
The amendment is expected to pass with relative ease. Republicans will join with anti-choice Democrats to push it over the finish line. Once the amendment passes, the bill is cleared for a vote, and all parties expect that vote to succeed. Today looks likely to end with a historic, and important, vote. A vote that is a first step towards helping more than 30 million people secure health-care coverage, and making sure hundreds of millions are better protected from the vagaries of the insurance industry. But Stupak’s amendment is a bitter start. It is, however, not the end. Even if it muscles into the House bill, it will also have to pass in the Senate, and then survive conference, before it becomes law.
Illinois Democrat Jan Schakowsky told C-SPAN’s “Washington Journal” that she’ll vote for the bill’s passage today, even with the Stupak amendment, but would opposed the final bill if the amendment survives the conference committee.
“If that language were in the final final bill, I certainly couldn’t support it,” Schakowsky said.
Plus: This morning, members of the Democratic Women’s Caucus went to the microphone, one by one, to explain how the overall health care bill would benefit women. Republican Rep. Tom Price of Georgia responded with a stream of “I object. I object. I object.” It got ugly.
Here’s a five-minute video showing what went down; if you’re short for time, below is the “I object” mashup created by Media Matters.
Those of you who are engaged in conversations with opponents to a public health insurance option might want to try pulling them away from Fox News for a moment and ask them to read Ellen Shaffer’s new piece, “U.S Health Care: Myths and Facts.”
- Raising Women’s Voices has coverage of a teach-in on health reform held at Columbia University on Oct. 22. Sponsored by the Student Committee of the Public Health Association of NYC and the Black and Latino Caucus of the Mailman School of Public Health, the event drew nearly 60 students, faculty and members of the community.
If you want to sponsor a teach-in on a college campus, contact RWV: info [at] raisingwomensvoices [dot] org for sample materials and programs. And check RWV’s calendar for upcoming events and speak-outs.
- Organizing for America received around a thousand videos made by healthcare advocates; here are the 20 finalists for your vote. The winner’s video will air on national television.
Update (2:52 p.m.): Final vote — Senate Finance Committee passes health reform bill by a vote of 14-9, with Sen. Olympia Snowe the lone Republican voting in favor.
Update: Public option supporter Sen. Jay Rockefeller will also vote “yes.”
The Senate Finance Committee is expected to vote on health reform legislation proposed by Sen. Max Baucus (D-Mont.) this afternoon or evening. The bill is expected to make it out of committee, but one of the lingering questions had been whether it would pass with or without the support of Sen. Olympia Snowe (R-Maine). It’s no longer a question — Snowe announced she will break with her party and support the Finance Committee bill.
“Is this bill all that I want? Far from it,” Snowe said. “Is it all that it can be? Far from it. But when history calls, history calls.”
She noted that consequences of inaction “dictate the urgency of Congress to take every opportunity to demonstrate its capacity to solve the monumental issues of our time.” (Listen to Snowe’s full statement at NPR.)
There’s no guarantee Snowe will vote for future versions of the legislation, and it remains to be seen how much Democrats will have to bend to keep the Maine Republican on board.
For more from today’s committee vote, Katherine Q. Seelye is live blogging at The New York Times blog Prescriptions.
More healthcare reading:
- “As the manipulation, posturing and bickering over health reform led primarily by conservative male congressional leaders, pundits, anti-choice organization leaders and ‘anti-reform town hall’ groupies drones on, the Democratic women of the Senate stepped up,” writes Jodi Jacobson at RH Reality Check, describing the actions of eight female senators last week.
“The Senators’ obvious frustrations — and even anger — at the slow progress on health reform legislation, the fact that untold numbers of Americans continue to become ill or die due to lack of timely health care, and the political games being with played reproductive health services was refreshing, frank, and long overdue,” continues Jacobson.
- Clark Hoyt, The New York Times public editor, on Sunday provided a behind-the-scenes look at the newspaper’s approach to covering health care reform, and he explained new features created to help readers understand the policy debate. In addition to the Prescriptions blog mentioned above, OBOS readers may also be interested in a new online forum, Health Care Conversations, which invites readers to comment on 20 healthcare-related topics, including popular conversation starters such as the public option and single-payer healthcare. Less busy is the forum on women and healthcare.
The vote on the Senate Finance Committee health reform bill has a date: Tuesday, Oct. 13.
The decision comes one day after the Congressional Budget Office reported that the committee’s legislation would cover 29 million uninsured Americans but would still slow the growth of spending and would reduce deficits by a total of $81 billion over a decade.
“Despite the expansion of coverage at a cost of $829 billion over 10 years, the budget office said 25 million people — about one-third of them illegal immigrants — would still be uninsured in 2019,” reports The New York Times. “In all, it said, the proportion of nonelderly Americans with insurance would rise over the 10 years to 94 percent, from 83 percent today.”
Meanwhile, House Speaker Nancy Pelosi (D-Calif.) today said that she’s going to send the CBO multiple variations of a health care bill that combines legislation from three different House committees. Ben Pershing at the Washington Post writes:
Pelosi said Thursday that she would send one bill to the CBO with what she called a “robust public option,” that would reimburse health-care providers at 5 percent above Medicare rates. The other two versions would have rates negotiated between the government and providers. “There’s no question that the robust public option scores very well,” Pelosi said, emphasizing that the first version would cost less but acknowledging that it might not be able to garner the 218 votes needed for passage. (Democrats hold 256 seats in the House.) “It’s very close,” she said.
Despite that split in her caucus, Pelosi said she felt “we’re in a very good place, because we have many good options. … There will be the votes for a public option. Now it’s a question of which one.”
After Pelosi gets the CBO’s analysis back, Democratic leaders and the House Rules Committee will complete the job of assembling a bill for floor consideration. The leadership has already ruled out bringing a bill to the floor next week, so the week of Oct. 19 would be the earliest time a vote would occur.
Speaking of a government-run insurance option, a new Qunnipiac University poll shows public support is running 2-to-1, with 61 percent in favor and 34 percent opposed. Other findings: “By a 57-37 percent margin, voters say Congress should not approve a health care overhaul with only Democratic votes. Democrats are OK with a one-party bill 63-29 percent, but opposition is 88-9 percent from Republicans and 62-32 percent from independent voters.”
* Health Care Bills Tackle Gender Gap in Coverage: USA Today reports on efforts to include provisions in health care legislation that would ban insurance companies from charging women more for the same policies as men and require companies to provide maternity coverage in their basic plans.
See our previous coverage on this subject, featuring the best line of the 2009 HCR debates: The response by Sen. Debbie Stabenow (D-Mich.) to Sen. John Kyl (R-Ariz.) when he questioned why maternity coverage should be mandatory when he doesn’t need it — “I think your mom probably did.”
* Health-Reform Anxiety: One Doctor’s Perspective: Anne Brewster, an internist and instructor in medicine at Harvard Medical School, left primary care medicine because she says she “felt unable to care for patients the way I wanted to within the constraints of the current system.”
Now an an urgent-care provider in Boston, Brewster, who is also an Our Bodies Ourselves board member, has written an essay for WBUR public radio on whether health reform will empower doctors.
“Reform should make my job more, not less, satisfying,” writes Brewster. “Of course, doctors should be expected to offer the highest quality care in the most cost-effective manner, but policies must be built on a foundation of trust in physician motivation and competency. Most physicians have a sound knowledge base, and are driven by a genuine desire to take care of people and ‘do no harm.’ Professional autonomy must be protected. Instead of imposing mandates and restrictions from above like an authoritarian parent, policy makers should work to provide physicians with the tools to meet these expectations.” Continue reading …
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.”
The Senate Finance Committee today rejected two proposals to add a public option — a government-sponsored insurance policy that would compete with private plans — to the health care reform bill put forth by Senator Max Baucus (D-Mont.).
David M. Herszenhorn of The New York Times writes:
The committee on Tuesday afternoon voted, 15 to 8, to reject an amendment proposed by Senator John D. Rockefeller IV, Democrat of West Virginia, to add a public option called the Community Choice Health Plan, an outcome that underscored the lack of support for a government plan among many Democrats.
Mr. Baucus voted no, as did Senators Thomas R. Carper of Delaware, Kent Conrad of North Dakota, Blanche Lincoln of Arkansas, and Bill Nelson of Florida, joining all 10 Republicans in opposition.
A second amendment by Senator Charles E. Schumer, Democrat of New York, to create a different version of a public plan was also defeated, though by a closer margin, 13 to 10, with the added support of Mr. Carper and Mr. Nelson.
Mr. Schumer who voted in favor of both proposals, said supporters of the public option would keep on fighting.
“We are going to keep at this and at this and at this until we succeed, because we believe in it so strongly,” he said.
This story in The Hill on the public option was published before today’s vote, but it’s worth reading for a look at the compromise Senate Majority Leader Harry Reid (D-Nev.) will try to forge between what emerges from the Finance Committee and the Senate’s Health, Education, Labor and Pensions Committee bill, which includes a strong public option. Polls show solid public support for a public option.
Plus: Have you seen this video of Robert Reich explaining the public option? He’s quite clear and concise.
Women received a serious wake-up call Friday when Sen. John Kyl (R-Ariz.) questioned why his insurance should include maternity care. A comment left on my post asks, “Why require this in EVERY plan? Won’t that just raise costs? Men don’t need it, working feminist women who don’t have children certainly don’t either.”
Hmmm. Without taking that bait, I will say that the commenter, as well as the senator, apparently is unaware that insurance works on pooling of risks. While it might be interesting to see what Kyl’s personal a la carte health insurance plan might look like, such individual choice would not be practical or affordable so long as insurance companies seek to maintain the same level of profit. Not to mention that what one person thinks he or she needs today can change overnight. Can you imagine all the “pre-existing condition” denials?
There’s also the issue of wanting to improve health outcomes for all mothers and children, but clearly that’s not Kyl’s priority.
Already, insurance carriers are free in most states to charge women and men different premiums for individually purchased insurance under a practice known as gender rating, as this report (pdf) from the National Women’s Law Center explains.
Nancy Folbre, an economics professor at the University of Massachusetts, Amherst, notes that women are often discriminated against when they try to buy individual health insurance, in part because pregnancy and family planning require more health care. “The typical American woman who wants to have two children will spend about five years being pregnant, recovering from pregnancy or trying to get pregnant, and about 30 years trying to avoid unintended pregnancies,” Folbre writes in a post at the The New York Times Economix blog.
Maternity isn’t the only way in which women are penalized. Looking at health care coverage over a lifetime, Folbre makes a clear case for why reform is essential for women, starting with the point that for many women, their insurance is tied to their husband’s work. A job loss or divorce leaves them vulnerable to having no insurance. (This is one of the reasons Our Bodies Ourselves is in favor of a single-payer system, because coverage would be independent from marriage or employment.)
Folbre continues:
Although fewer adult women than men lack health insurance, they seem to be more affected by insurance-related problems, including inadequate coverage. A Commonwealth Fund study released last May found that about 52 percent of working-age women, compared to 39 percent of working-age men, reported in 2007 that they had to forgo filling a prescription, seeing a specialist, obtaining a recommended medical test or seeing a doctor at all as a result of medical costs.
In striking testimony to financial vulnerability, more than one-half of all bankruptcies related to medical costs in the United States in 2007 were filed by female-headed households.
Women in their 50s and early 60s who are married to older men face a distinctive risk — loss of access to their husband’s employer-related coverage when he makes the transition to Medicare but they are not yet old enough to be eligible. The resulting disruption in coverage often has adverse effects on their health.
Women are important health care providers as well as consumers. Over 59 percent of informal, unpaid caregivers are women, and women devote significantly more time to the care of sick, disabled and elderly family members than men do. Indeed, such commitments help explain why women are more likely than men to work part time and to exit the paid labor force for longer periods of time.
You’re so right! Thanks for this well-written commentary. Women’s health activists have known all this for a long-time & many of us are organizing in support of health reform. Remember Our Bodies, Ourselves? They’re just one of many women’s health groups working on this issue. Check out Raising Women’s Voices for the Health Care We Need, SisterSong, National Women’s Health Network and others.
Plus: In other health care news today –
* Katherine Seelye is live blogging the Senate Finance Committee debate on the public option. Democratic senators Charles Schumer of New York and David Rockefeller of West Virginia have proposed separate public option amendments (view Rockefeller’s and Schumer’s, both pdf’s). The debate was postponed from Friday. You can watch live here.
* David Kirkpatrick writes about how the health care reform debate has become a fight over abortion.
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