Judith L. Lichtman
It is always a terrible shame when politics gets in the way of the imperative to meet the health care needs of women.
At the National Partnership, we remain fully committed to health care reform that guarantees universal access to high quality, affordable reproductive health services – including family planning, maternity care, and abortion. Despite the importance of these services to women, reproductive health has – predictably enough – emerged as a divisive issue in the ongoing health care reform debate.
Specifically, anti-choice politicians and advocacy groups have ramped up efforts to use health care reform as a vehicle to undermine access to abortion services, although much of what is being said about abortion coverage bears little relationship to the actual proposals being debated in Congress. In reality, abortion coverage is not mandated by any of the four bills that have been marked up in the House and Senate – despite high-pitched assertions to the contrary.
Three of the four bills considered by House and Senate Committees to date merely allow reproductive health services to be treated the same as all other primary care health care services – meaning that an advisory committee or the HHS secretary would make a determination about coverage. The more conservative House Energy and Commerce committee approved a bill which takes a dramatically different approach – one designed to reflect an abortion truce that maintains the status quo at best. The legislation passed by that Committee addresses abortion coverage most explicitly – and in fact makes clear that abortion services cannot be included in the “essential benefits package” that plans would be required to offer.
The Energy and Commerce Committee legislative language clearly states that health plans participating in exchange are neither prohibited nor required to include abortion coverage. Instead, the Committee language is designed to allow women to retain the type of coverage they currently have. Consistent with current practice in the private health insurance market, the amendment authored by Representative Lois Capps (D-CA) would allow – not require – insurers to sell policies to individuals and some small businesses through a national insurance exchange that include abortion coverage.
The Capps language also addresses concerns that plans participating in the exchange that receive federal dollars not use those government funds to pay for coverage of abortion services by requiring that coverage for any abortion services provided for reasons other than those allowed under the Hyde amendment (rape, incest or danger to the woman’s life) be paid for out of private premiums. Under the Capps language, both public and private plans could cover abortion services – but with private dollars. In addition, the Capps amendment would not pre-empt state laws regulating abortion and restrictions on state Medicaid coverage of abortion would continue – meaning that the federal funds could not be used to provide abortion services except in cases of rape, incest or danger to the woman’s life.
It is always a terrible shame when politics gets in the way of the imperative to meet the health care needs of women. For women, reproductive health services are basic health services, and lawmakers should remember that. Efforts to limit coverage of abortion services are really attempts to deny women access to health care services that are legal, necessary, and that one-third of American women will need during the course of their reproductive lives.
