Sunday, November 08, 2009

Health Reform Passes House with Stupak

Erica Werner's write-up for the AP is below:

House votes strict ban on abortion subsidies

WASHINGTON — A bipartisan House coalition voted Saturday to prohibit coverage of abortions in a new government-run health care plan that Democrats would establish to compete with private insurers.

The 240-194 vote on an amendment by Rep. Bart Stupak, D-Mich., was a blow to liberals, who would have allowed the Obama administration and its successors to decide whether abortions would be covered by the government plan. Sixty-four Democrats joined 176 Republicans in favor of the prohibition.

Stupak's measure also would bar anyone from getting federal subsidies to help cover their premiums for private insurance polices that would include abortion coverage.

"Let us stand together on principle — no public funding for abortions, no public funding for insurance policies that pay for abortions," Stupak urged fellow lawmakers before the vote.

The amendment would bar the new government insurance plan from covering abortions, except in cases of rape, incest, or where the life of the mother is in danger. The Democrats' original legislation would have allowed the government plan to cover abortions, if the Health and Human Services secretary decided it should.

The amendment also would prohibit people who receive new federal health subsidies from buying insurance plans that include abortion coverage.

The Democrats' original bill would have allowed people getting federal subsidies to pay for abortion coverage with their own money. Abortion opponents dismissed that as an accounting gimmick.

Abortion rights advocates called the measure the biggest setback to women's reproductive rights in decades.

"Like it or not, this is a legal medical procedure and we should respect those who need to make this very personal decision," said Rep. Diana DeGette, D-Colo.

Some Republicans considered voting "present" in hopes that might unravel support for the underlying health care bill among anti-abortion Democrats, but only one did, Rep. John Shadegg, R-Ariz.

"If I felt that the (health overhaul) bill could be killed by not advancing the Stupak amendment then it seems it would be prudent to vote in such a way that wouldn't advance the bill, but it doesn't appear that that's a possibility," Rep. Michele Bachmann, R-Minn., said before the vote.

The National Right to Life Committee and the U.S. Conference of Catholic Bishops lobbied lawmakers in both parties on the abortion measure. The bishops said they would oppose the bill if it lacked a strict prohibition on any federal funding for abortions.

Stupak's language applies to policies sold in a federally regulated insurance exchange that would be set up in 2013. The overhaul bill envisions both private companies and the government offering policies in the exchange.

Under the Stupak amendment, people who do not receive federal insurance subsidies could buy private insurance plans in the exchange that include abortion coverage. People who receive federal subsidies could buy separate policies covering only abortions if they use only their own money to do it.

Companies selling insurance policies covering abortions would be required to offer identical policies without the abortion coverage.

Abortion-rights supporters say private insurers will not likely offer policies with abortion coverage in the exchange because many potential buyers will be getting federal subsidies.

Around 21 million people are expected to get coverage through the exchange by 2019, according to the Congressional Budget Office. The majority of Americans who get their insurance coverage from their employers would not be affected.

Abortion-rights supporters say the restrictions in the amendment go further than current law.

A law called the Hyde amendment — which must be renewed annually — bars federal funding for abortion except in cases of rape, incest or if the mother's life is in danger. The restrictions apply to Medicaid, forcing states that cover abortions for low-income women to pay for them with state revenues. Separate laws apply the restrictions to the federal employee health plan and the military.

Currently abortion coverage is widely available in the private market. A Guttmacher Institute study found that 87 percent of typical employer plans covered abortion in 2002. A Kaiser Family Foundation survey in 2003 found that 46 percent of workers in employer plans had abortion coverage. The studies asked different questions, which might help explain the disparity in the results.

Abortions in the first trimester typically cost between $350-$900, according to Planned Parenthood.

A health overhaul bill pending in the Senate also bars federal funding for abortion, but the language is less stringent. Discrepancies between the House and Senate measures would have to be reconciled before any final bill is passed.


Ella from Toronto said...

I don't think this is about woman rights. Nobody is told they can't have it done, right? It's just that state will not participate in funding it.

Everything cost money.. to have a child and not to have a child. But why the state should be involved in the latter I don't really understand.


Lazy Disciple said...


I think your understanding is correct, as far as it goes: no supposed "right" to abortion is threatened by the government's refusal to pay for its exercise.

I do not think that there is a right to abortion, but that is another matter.


Kevin in Texas said...

Great posts from both you and HP lately, LD, and I'm pleased to have "found you" again via Clayton's blog! Now your blog is firmly locked into my bookmarks menu! ;-)

Moving beyond the abortion issue, which I am very pleased to have seen dealt with at least in the House bill via the Stupak amendment, I find more interesting in a global sense that which you point out in this post, LD, namely the cost-benefit analyses that could be done on other government-run health systems around the world. How difficult would it be for some panel consisting perhaps of a couple of each--economists, doctors, accountants, health care administrators, sociologists, and politicians--to do an objective analysis of differing models of government-run or subsidized health care systems in places like Europe, Asia, and North and South America?

My sense is that the greater difficulty would be found in trying to remain objective in one's methods of analysis and interpretation of the results found. Everyone has a bias, it's as natural as breathing for fallen humans. But our biases are also strongly influenced in political matters by things like funding sources and personal political preferences--money talks in our capitalist system.

I apologize for the stream-of-consciousness nature of this comment, but it just seems to me that the logical and natural precursor to such a major issue like health care reform in such an enormous country like the U.S. should be a relatively non-partisan and objective study or cost-benefit analysis of other systems that have been tried and implemented worldwide.

Lazy Disciple said...

Dear Kevin,

Thanks so much for visiting and commenting - and please, don't sweat the "stream of consciousness".

Actually, it strikes me that your remarks flow quite coherently. If it was a stream, then it was a slow, tranquil stretch of water with, I am quite sure, some nice, quiet holes to fish.

I like your thinking on the question of cost-benefit analysis, though I also think you answer your own question.

How to gather the data? How to filter the data? How to crunch the data? These are all "political" questions, if you will, which must be answered beforehand.

What constitutes an acceptable c/b ratio? An optimal ratio? What can we do to make it happen in the US?

Did you happen to see John Allen's take on the economics of health reform over at NCR?

I am going to have something up on it by the end of the day - it's just after 5AM over here.


Ella from Toronto said...

If I may again step in this debate, I think one of the biggest problems here is that the health care system reform comes from the federal government. I see the federal government is as far away from the people and the real issues as it can be. I'd different states have different needs, different demographics, different economic situation. They should get a chance to deal with this on their own.

Or am I completely missing it?


Lazy Disciple said...

Dear Ella,

I do not think you are so much missing it, as not realizing that there are state-level health programs. Blue Cross/Shield and others are examples.

The Federal Government does have a role to play in this, because, with the mobility of people and the fluidity of the labor market, providing health care is inevitably a matter of interstate commerce (Cf. Constitution of the United States, Art.1s.8c.3).

I am going to have something up on this later in the day. Keep checking in.