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Not-so-choice: The House health reform unduly restricts abortion
Thursday, November 12, 2009

One of the last-minute compromises in the House-passed health insurance reform bill imposes unnecessary new restrictions on coverage for abortion. This is fresh evidence that although a woman's right to choose has been established law for 36 years, opponents continue to chip away at it.

The amendment was sponsored by Michigan Democrat Bart Stupak and, on a vote of 240-194, passed far more easily than the overall bill. It would continue a 30-year practice of prohibiting the use of federal funds for abortions, but it goes further.

Here's how. The health-care bill establishes an insurance exchange in which previously uninsured people, as well as those whose policies are inadequate or too expensive, would be able to purchase coverage either from private companies or from the so-called public option. The government will subsidize the costs of those whose incomes are less than 400 percent of the poverty level -- $88,000 for a family of four, for instance.

Under the Stupak amendment, no one with a public subsidy can use it to purchase health insurance that covers abortion, a restriction that today applies only to low-income women on Medicaid; federal employees, their spouses and dependents; women in the military overseas; women in federal prisons and those who live in the District of Columbia.

In addition to expanding the pool of people who are covered by the restriction, the amendment likely will mean that firms selling policies on the exchange won't include coverage for abortions because no one getting a subsidy will be able to buy them. That means even customers using their own money to buy coverage probably won't be able to find an insurer who will provide it on the exchange, where all of the nation's major insurers are expected to participate.

Women seeking abortion coverage would have to buy separate insurance riders, plans that are hard to come by even in the five states (Idaho, Kentucky, Missouri, North Dakota and Oklahoma) that already bar private plans from covering elective abortions.

It is the nature of compromise that nobody gets everything they want, and the health-insurance bill passed by the House is better than no plan at all. But a previous version of the bill would have adequately segregated federal money away from abortion services without extending the restrictions so significantly.

Health coverage for women routinely is more expensive than for men. With this misguided amendment, it stands to be less comprehensive, too.

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First published on November 12, 2009 at 12:00 am