Health Law Rolls Back Abortion Rights, Groups Say
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http://www.npr.org/templates/story/story.php?storyId=126000118
April 15, 2010
Recent fights between anti-abortion groups could leave people with the impression that the new health overhaul law expands women's access to abortion. But abortion-rights groups vehemently disagree.
"There are extraordinary things in health care reform for women," says Judy Lichtman, a senior adviser to the National Partnership for Women and Families, which supports abortion rights. "But all, I have to admit, come at the expense of women's abortion rights, and that's very sad."
Timothy Jost, a law professor at Washington and Lee University in Virginia, agrees. "I think across the board this is a bill that is a pro-life bill and is going to lead to fewer rather than more abortions. And I think it's very unfortunate that people who oppose this bill for other reasons are attacking it as an abortion-funding bill, which it definitely is not."
Opponents Push To Fully Exclude Abortions
But abortion opponents are not satisfied with the restrictions on abortion already in the measure, particularly those on abortion coverage in private plans that will be sold in the new marketplaces known as health "exchanges." So they are pushing one particular aspect of the new law. It lets states ban all abortion coverage in the exchanges.
Charmaine Yoest, president and CEO of anti-abortion group Americans United for Life, said her group wasted no time drawing up a model state law to that effect. They sent it out the day after Congress approved the health bill.
"It was a part of the legislation that states could opt out, and so we had a heads-up that this would be a window for us," she said. "So we moved right in to make sure that we could equip states with the tools that they need to have the most effective opt-out possible."
So far at least three states -- Missouri, Tennessee and Louisiana -- are already moving legislation to ban abortion coverage in the exchanges. And that's even though the exchanges themselves don't have to be up and running until the year 2014.
Treading On Complicated Waters
A full ban would seem to undermine the uneasy truce between abortion rights supporters and opponents that was in place as the new law was being written; that it should neither expand nor contract existing abortion policy. Federal abortion funding is currently allowed in cases of rape, incest or when the life of the women would be endangered by carrying the pregnancy to term.
But where that got complicated was in those new health insurance exchanges, because that's where the federal government would subsidize many people's private policies.
Even if states don’t ban abortion coverage in the exchanges completely, abortion rights advocates say the new federal health law is likely to make abortion less available for many women.
That's because, says Lichtman, until now, "it has been the norm that private health plans provide abortion coverage." But while the new law does allow health plans in the exchange to offer abortion coverage, "it does so in a way that creates serious disincentives to providing the coverage and very serious disincentives for people buying it."
Bill Already Requires A Separate Policy
Under the law, insurance plans can offer coverage for abortion only if they offer it as a separate policy. Individuals or their employers will have to write two separate checks each month, one for the abortion coverage and one for all other coverage. And those premiums will have to be kept in separate accounts.
Law professor Jost says he thinks that will all but eliminate health coverage for abortion in the new exchanges. "This segregation of funds and strict auditing of the funds is going to be a real hassle for insurers; it's going to be a real hassle for consumers," he says. "And markets are going to lead people to the low cost, low hassle solution, which is going to be plans that do not cover abortion."
Yet many women don't realize their plans don't cover abortion until it's too late.
Take D.J. Feldman. In 2008, the federal lawyer had a fetus diagnosed with anencephaly -- a birth defect where the brain, skull and spinal column fail to connect. Her doctor said an abortion was medically necessary. But her insurance claim was denied. That's because federal health plans have been barred from offering most abortion coverage since the 1990s.
"Our medical experts determined that you could have carried to term, because your life was not in danger," she quoted from the denial letter. "And by the way, you owe $9,000."
It's a story that could become more common for women buying insurance in the new marketplaces.
April 15, 2010
Recent fights between anti-abortion groups could leave people with the impression that the new health overhaul law expands women's access to abortion. But abortion-rights groups vehemently disagree.
"There are extraordinary things in health care reform for women," says Judy Lichtman, a senior adviser to the National Partnership for Women and Families, which supports abortion rights. "But all, I have to admit, come at the expense of women's abortion rights, and that's very sad."
Timothy Jost, a law professor at Washington and Lee University in Virginia, agrees. "I think across the board this is a bill that is a pro-life bill and is going to lead to fewer rather than more abortions. And I think it's very unfortunate that people who oppose this bill for other reasons are attacking it as an abortion-funding bill, which it definitely is not."
Opponents Push To Fully Exclude Abortions
But abortion opponents are not satisfied with the restrictions on abortion already in the measure, particularly those on abortion coverage in private plans that will be sold in the new marketplaces known as health "exchanges." So they are pushing one particular aspect of the new law. It lets states ban all abortion coverage in the exchanges.
Charmaine Yoest, president and CEO of anti-abortion group Americans United for Life, said her group wasted no time drawing up a model state law to that effect. They sent it out the day after Congress approved the health bill.
"It was a part of the legislation that states could opt out, and so we had a heads-up that this would be a window for us," she said. "So we moved right in to make sure that we could equip states with the tools that they need to have the most effective opt-out possible."
So far at least three states -- Missouri, Tennessee and Louisiana -- are already moving legislation to ban abortion coverage in the exchanges. And that's even though the exchanges themselves don't have to be up and running until the year 2014.
Treading On Complicated Waters
A full ban would seem to undermine the uneasy truce between abortion rights supporters and opponents that was in place as the new law was being written; that it should neither expand nor contract existing abortion policy. Federal abortion funding is currently allowed in cases of rape, incest or when the life of the women would be endangered by carrying the pregnancy to term.
But where that got complicated was in those new health insurance exchanges, because that's where the federal government would subsidize many people's private policies.
Even if states don’t ban abortion coverage in the exchanges completely, abortion rights advocates say the new federal health law is likely to make abortion less available for many women.
That's because, says Lichtman, until now, "it has been the norm that private health plans provide abortion coverage." But while the new law does allow health plans in the exchange to offer abortion coverage, "it does so in a way that creates serious disincentives to providing the coverage and very serious disincentives for people buying it."
Bill Already Requires A Separate Policy
Under the law, insurance plans can offer coverage for abortion only if they offer it as a separate policy. Individuals or their employers will have to write two separate checks each month, one for the abortion coverage and one for all other coverage. And those premiums will have to be kept in separate accounts.
Law professor Jost says he thinks that will all but eliminate health coverage for abortion in the new exchanges. "This segregation of funds and strict auditing of the funds is going to be a real hassle for insurers; it's going to be a real hassle for consumers," he says. "And markets are going to lead people to the low cost, low hassle solution, which is going to be plans that do not cover abortion."
Yet many women don't realize their plans don't cover abortion until it's too late.
Take D.J. Feldman. In 2008, the federal lawyer had a fetus diagnosed with anencephaly -- a birth defect where the brain, skull and spinal column fail to connect. Her doctor said an abortion was medically necessary. But her insurance claim was denied. That's because federal health plans have been barred from offering most abortion coverage since the 1990s.
"Our medical experts determined that you could have carried to term, because your life was not in danger," she quoted from the denial letter. "And by the way, you owe $9,000."
It's a story that could become more common for women buying insurance in the new marketplaces.
Post edited by Unknown User on
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Comments
Our government is the potent, the omnipresent teacher. For good or for ill, it teaches the whole people by its example. Crime is contagious. If the government becomes a law-breaker, it breeds contempt for law; it invites every man to become a law unto himself; it invites anarchy. - Louis Brandeis
Well they weren't mandated to pick up the costs before - it was more neutral; insurance companies could do what they wanted, but many policies chose to cover it. But now it's mandated that private insurance policies are NOT ALLOWED to cover it on the primary policies. Women will have to get whole separate policies for abortion coverage, and it's set up so that 1) Women will have to jump through a bunch of extra hoops to get these extra policies; 2) Insurance companies will have to jump through a bunch of extra hoops to offer these policies; and 3) States can actually ban insurance companies from even offering these extra policies at all.
So it went from a neutral, the government's not going to tell private insurance companies what they can and can't cover, kind of situation to a situation where the government is discouraging and providing disincentives for coverage at best and even outright banning coverage in some states. (This is in addition to the bans that were already in place for insurance policies that covered government employees, Medicaid, military personnel and dependents, Native Americans using Indian Health Services, etc.)
As far as whether or not someone can still get an abortion, it will still be legal but access will be greatly reduced. More than half of abortions in the U.S. are to women who live at less than 200% of the federal poverty level, so banning or decreasing insurance converage is quite prohibitive.
The main point being: Both sides had agreed to not use this bill to change abortion access and that didn't happen; it was instead used to decrease it.
Our government is the potent, the omnipresent teacher. For good or for ill, it teaches the whole people by its example. Crime is contagious. If the government becomes a law-breaker, it breeds contempt for law; it invites every man to become a law unto himself; it invites anarchy. - Louis Brandeis
But no one's saying they should be EXPECTED to pay for it. They're saying private insurance companies shoudln't be BANNED from paying for it if they want to. They're also just pointing out this bill did not maintain the status quo, as promised.
Let me ask you this: Do you feel this exact same way about all other medical care?
As for your question, at some point much of these discussions simply boil down to personal responsibility and accountability on some level or degree. Does that mean people shouldn't get coverage or care if they are irresponsible, of course not, but it does become a topic of discussion. For example, all the talk of our healthcare debate, programs and budgets - yet zero talk about how our citizens don't take care of themselves which is probably the biggest or one of the biggest reasons these costs are out of control. People don't want to discuss that fact because of infringement and freedoms, but in reality, people don't take care of themselves, have more health issues and need more care. I don't know how you dictate policy and programs to fix it in practice, but it really is the heart of the issue. Which brings me back to this thread topic, some degree of accountability and responsibility should fall on the people wanting these abortions and if that means costs, then so be it. To me, in all the insurance and healthcare debate, abortion isn't high on my list of importance, so it's second-nature to look at it this way, but perhaps for some others it's higher and more important. Just my 2 cents.
Our government is the potent, the omnipresent teacher. For good or for ill, it teaches the whole people by its example. Crime is contagious. If the government becomes a law-breaker, it breeds contempt for law; it invites every man to become a law unto himself; it invites anarchy. - Louis Brandeis
I just think it's important that all medical care is held to the same standard instead of people's personal opinions/morality/religion dictating healthcare policies. Obviously that was allowed to happen with this law, but I wondered if you were judging it in the same way.
I think personal responsibility and the cost of people not taking care of themselves is being discussed in many ways, though. Just right now on this board we're having discussions about bicycle helmets, car seats, obesity, etc.
I also think there are many ways to address this through policies and programs. Regulation (such as car seat mandates and sin taxes) is one way, though it's contentious. Education is another way, and this is addressed to some extent in the new healthcare reform law (e.g. sex ed). And access to preventative care and other means by which people can take care of themselves is another huge way to address this issue. Again, this healthcare reform addresses this by improving access to preventative care. It can also be addressed with smoking cessation programs, community food co-ops, sidewalks, family planning programs, funding of lactation consultants, school lunch programs, suicide hotlines, drug treatment centers, parks, improved law enforcement, gun safety classes, school-based health programs, and countless other policies and programs that support people in making healthy decisions. And the best part is, we all have the power to do something to promote healthier communities!
Our government is the potent, the omnipresent teacher. For good or for ill, it teaches the whole people by its example. Crime is contagious. If the government becomes a law-breaker, it breeds contempt for law; it invites every man to become a law unto himself; it invites anarchy. - Louis Brandeis
I see your point. But in your analysis of what people do/don't do to take care of themselves (or not), do you look at reasons (NOT excuses) for their (in)action and what you can do to help the situation? I've found that so many people (not necessarily you) talk about personal responsibility, and that's important - but then they stop there. But there are so many parts to every situation.
For instance, to kind of get back to the topic, people complain incessantly about unintended pregnancy and abortion, and then chalk it all up to a failure of personal responsibility and leave it at that. ("She should have kept her legs closed." "It's not that hard to get contraception.") Is it true that a woman could have avoided pregnancy had she used contraception? Frequently it is true. (Though we have to be careful about overgeneralization and assumptions when we don't know everyone's specific experience.) Is anyone saying she should be able to avoid pregnancy without taking the initiative to "be responsible"? No.
But then, instead of just blaming "those women" and their lack of personal responsibility, why don't we take it further to ask ourselves what factors influence a woman's decision to not use contraception and what we can do to improve the situation if it bothers us so much? How can we create an environment that will make it more likely that women - and men - will use contraception? (I'm not talking about making excuses.) One huge reason many women don't consistently use contraception is because of poor access. We KNOW for a fact that we can decrease unintended pregnancy on a population level if we, as a society, improve access to contraception. So why don't we do it? Education is another important factor that we have the power to improve. Plus, men (as a group) have huge power to prevent/reduce the risk of unintended pregnancy.
I would encourage people to move past the blame part and ask themselves what they can do to create/support the change they want to see in the world.
Lastly, I'm not looking to simply push blame (some do that), I'm simply saying there is an accountability and responsibility factor involved. As the saying goes, it takes a community to raise a child - not sure where you live, but I don't have so much faith in society when I look around.
Our government is the potent, the omnipresent teacher. For good or for ill, it teaches the whole people by its example. Crime is contagious. If the government becomes a law-breaker, it breeds contempt for law; it invites every man to become a law unto himself; it invites anarchy. - Louis Brandeis
Great quote! I'm not sure what you mean when you say society doesn't want the things I'm discussing. Do you mean they don't want people to have access to contraception? If so, do you mean for religious reasons or just on the grounds that they don't want to support better access to healthcare? I think it's only a very small part of society that wants to prevent people from accessing contraception.
How do we fix it? We vote! We advocate for policies and programs that will improve the situation. We educate people. (Some people really do want to learn... and some just never thought about some of the things we can do to help.) We find consensus and build on it. We coordinate programs of our own. Reminds me of a couple of quotes:
I know you're not looking to simply push blame and I agree that there's an accountability and responsibility factor involved. I just thing too many other people want only to push blame, to the exclusion of taking the responsibility to do what they can to help the situation.
Our government is the potent, the omnipresent teacher. For good or for ill, it teaches the whole people by its example. Crime is contagious. If the government becomes a law-breaker, it breeds contempt for law; it invites every man to become a law unto himself; it invites anarchy. - Louis Brandeis
~ Tennessee: The state Senate voted 27-3 to approve a bill (SB 2686) that would prohibit abortion coverage in health plans available in state insurance exchanges that will be created under the federal health reform law (PL 111-148), the Tennessean reports (Sisk, Tennessean, 4/20). The House approved the measure -- sponsored by Diane Black Gallatin, the state senate's Republican Caucus Chair -- earlier this month. It now goes to Gov. Phil Bredesen (D) for consideration (AP/WBIR, 4/19).
~ Oklahoma: The Oklahoma Senate on Monday approved five antiabortion bills, four of which previously were declared unconstitutional for violating a requirement that state bills address a single subject, the Tulsa World reports. One bill (HB 2780), approved 35-11, would require a woman seeking an abortion to undergo an ultrasound within one hour before the procedure and listen to an explanation of the ultrasound's findings. The bill would require doctors to use a vaginal probe [even for rape victims] in cases where it would provide a clearer picture of the fetus than a regular ultrasound. Another bill (HB 3075), approved 39-6, would require abortion clinics to post signs stating that women cannot be forced to undergo an abortion. In addition, the Senate voted 35-11 for a bill (HB 2656) that would prevent so-called "wrongful life" and "wrongful birth" lawsuits. All three measures now go to Gov. Brad Henry (D). The two other bills the Senate approved Monday now return to the state House. One measure (HB 3284) would require women seeking an abortion to provide detailed information that will be posted without their names on a state-run Web site. The bill would require women to provide information about their marital status, education level, method of abortion, reason for abortion, means of payment and previous experiences with abortion or miscarriage. The bill was approved 35-10. The final bill (HB 3290), passed 35-11, would ban coverage of abortion services by plans participating in the state insurance exchanges to be created under the recently approved national health reform law (Hoberock, Tulsa World, 4/20). A lawyer for the Center for Reproductive Rights said that if the bills become law, Oklahoma would have some of the nation's strictest abortion requirements (Murphy, AP/Google News, 4/19).