Breaking Down Abortion Language In Health Bill
The health care overhaul passed by the House of Representatives over the weekend was almost scuttled by one issue: abortion.
Anti-abortion Democrats and their leaders tried unsuccessfully to come to agreement about abortion language before debate began.
Instead, House Speaker Nancy Pelosi allowed Rep. Bart Stupak (D-MI) to offer an amendment on the floor to restrict federal funding for abortion services, even in private health insurance plans. The vote was 240-194.
Anti-abortion groups say this only codifies current law, which already bans federal funding for abortion. "Our amendment does one very simple thing," Stupak said on the floor. "It applies the Hyde amendment — which bars federal funding for abortion except in the case of rape, incest or the life of the mother — to the health care bill."
Abortion rights advocates argued that the Stupak amendment expands the ban well beyond the language in the Hyde amendment, passed in 1976. Colorado Democratic Rep. Diana DeGette, a leader among abortion rights lawmakers, warned that if enacted, "This amendment will be the greatest restriction on a woman's right to choose to pass in our careers."
To get a clearer picture of what the Stupak amendment would do, it helps to take it out of context and just look at the language. Here's what it says:
Government Money: In general, government money cannot be used to pay for abortion. The government-administered health plan — often called the public option — will not cover abortion, unless a doctor certifies that a woman is in danger of death without one, or the pregnancy is the result of rape or incest.
If you get your health insurance through the government, or with help from the government in the form of a tax subsidy, your plan will not cover abortion. In this case, you would have the right to buy extra coverage — with your own money.
If you get your health insurance through your state, as in Medicaid, your state could buy supplemental abortion coverage for everyone it insures. And 17 states already do this under Medicaid.
The Exchange: The next section of the abortion amendment deals with the exchange. That's the government-administered service where people can buy insurance and join a risk pool. One of the reasons health care is so expensive for people who don't get it through their work is that they're not in a large risk pool. The bill tries to group them together and cut costs for everyone.
Private insurance companies that offer a health plan through the exchange are allowed to cover abortion. But if they're going to, the companies must also offer another plan that is identical in every way, except that it does not cover abortion.
So, say you're buying insurance with your own money, and you get it through the exchange. You can choose a policy that covers abortion, or one that doesn't. But if you're getting help from the government to buy that insurance — in the form of a tax subsidy — you may not choose a plan that covers abortion. You are still allowed to buy a supplemental policy with your own money.
Private Insurance: The Stupak amendment does not apply to private insurance bought with private money. It is also not close to becoming law. The Senate bill does not have similar language, though lawmakers on both sides of the debate are now looking at it.
The question now is how this might play out in a whole new medical system, and what it means in the broader narrative of abortion in America.
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Paying for abortion has become a flashpoint in the health care debate. This weekend, the House approved its massive health care bill, but only after intense wrangling and the addition of an amendment that would limit insurance coverage of abortion. The move sparked a torrent of press releases and opining from both sides of the abortion issue, making it more difficult to figure out what the amendment would actually do.
For that, we turn to NPR's Andrea Seabrook.
ANDREA SEABROOK: It's called the Stupak Amendment, named for the anti-abortion Democrat who fought for it, Michigan's Bart Stupak. He says it maintains a basic principle thats been in U.S. law since 1976, the Hyde Amendment. That bars federal health insurance programs, like Medicaid, from paying for abortion services.
Stupak explained it this way.
Representative BART STUPAK (Democrat, Michigan): Our amendment does one very simple thing: it applies the Hyde Amendment, which bars federal funding for abortion except in the case of rape, incest or life of the mother to the health care reform bill.
SEABROOK: Abortion rights supporters say...
Representative DIANA DEGETTE (Democrat, Colorado): Nothing could be further from the truth.
SEABROOK: Colorado's Diana DeGette.
Rep. DEGETTE: If enacted, this amendment will be the greatest restriction of a woman's right to choose in our careers.
SEABROOK: DeGette and other pro-abortion-rights Democrats say this actually goes beyond the Hyde Amendment and would have much broader consequences for abortion services all around. Still, the Stupak Amendment won the votes of 39 Democrats, in part because of a strong lobbying effort from the U.S. Conference of Catholic Bishops.
So to get a clearer picture of what this thing would do, it helps to actually take it out of context for once. Forget Hyde, ignore what this means in the decades-old tug of war about abortion and just look at the Stupak Amendment.
Here's what it says, translated to plain English: In general, government money cannot be used to pay for abortion. The government-administered health plan, often called the public option, will not cover abortion unless a doctor certifies that a woman is in danger of death without one or the pregnancy is the result of rape or incest.
If you get your health insurance through the government or with help from the government in the form of a high tax subsidy, your plan will not cover abortion. In this case, you would have the right to buy extra coverage with your own money, if you choose to.
Now, if you get your health insurance through your state, as in Medicaid, your state could buy supplemental abortion coverage for everyone it insures. And 17 states already do this under Medicaid.
The next section of the abortion amendment deals with the Exchange. Thats the government-administered service where people can buy insurance and join a risk pool. Remember, one of the reasons health care is so expensive for people who dont get it through their work is that they're not in a large risk pool. So the bill tries to group them together and cut costs for everyone.
Private insurance companies that offer a health plan through the Exchange are allowed to cover abortion. But if they're going to, the companies must also offer another plan that is identical in every way, except that it does not cover abortion.
So, say, you're buying insurance with your own money and you get it through the Exchange, you can choose a policy that covers abortion or one that doesnt. But if you're getting help from the government to buy that insurance in the form of a tax subsidy, you may not choose a plan that covers abortion. You're still allowed to buy a supplemental policy with your own money.
And thats it. Thats what the Stupak Amendment says. It does not apply to private insurance bought with private money.
What everyone is fighting about now is how this might play out in a whole new medical system, and what it means in the broader narrative of abortion in America.
All eyes are now on the Senate to see how it deals with abortion in its version of the health care bill.
Andrea Seabrook, NPR News, the Capitol. Transcript provided by NPR, Copyright National Public Radio.
