TPMDC
Controversial Stupak Amendment Sows Anger, Confusion On Capitol Hill
Brian Beutler | November 9, 2009, 6:55PM
Rep. Bart Stupak (D-MI)
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When Rep. Bart Stupak (D-MI) authored an amendment several months ago to prohibit federal dollars from being used to pay for insurance policies that cover abortion, Democratic leaders and health care principals didn't take his proposal very seriously. As a result it was never subjected to the sort of rigorous analysis that controversial legislation is often treated to. That was a miscalculation. Liberals were forced this weekend to accept the amendment as the price of passing an otherwise progressive health care bill through the House. And now, everyone on both sides of the abortion issue is scrambling to try to figure out what the amendment's language actually means and the practical effect it would have if enacted into law.
As one House Democratic health care aide put it, "there are a ton of unanswered questions."
The letter of the amendment itself suggests that women who want to buy an insurance plan that covers abortion must not also be receiving government subsidies, provided for in the bill, to help cover their premiums. However, the overwhelming majority of women in the health insurance exchanges will be receiving subsidies from the government, and if any of them decide they want abortion coverage, under the terms of the Stupak amendment, they'd have to buy a supplemental plan paid for out of pocket.
That could reduce private insurers' incentive to offer any comprehensive plans that cover abortion--a view articulated by Jessica Arons, Director of the Women's Health and Rights Program at the Center for American Progress, and adopted by some lawmakers on the Hill. Arons writes, "As the vast majority of Americans in the Exchange will need to use some of these credits [aka subsidies], it is highly unlikely any plan will want to offer abortion coverage."
But in an interview with TPMDC, Arons suggests it may be even more complicated than that. One of the pillars of reform legislation is a provision called "guaranteed issue," which holds, basically, that insurers in the exchange must sell consumers whichever insurance policies they choose. However, the Stupak amendment would explicitly forbid people who are provided government subsidies from buying policies that cover abortion--and that contradiction could run afoul of the promise of guaranteed issue from day one.
"It's a somewhat open question about how those two provisions would interact," Arons says.
For the two measures to work in tandem, she says, either every plan in the exchange would have to be prevented from offering abortion coverage, or the guaranteed issue provision would have to be modified. "I would think there would have to be some sort of specific exemption to the guaranteed issue provision," Arons says.
How that would happen, or if it would even be necessary, remains unclear. There is some disagreement with this interpretation on the Hill. And that's sort of the point. "It hasn't been thought through," Arons said.
Ergo, confusion. In the ensuing weeks, as progressives and pro-choice activists work to get the amendment stripped from the final legislation, these arguments will be hashed out further by members, activists, and policy experts. More than 40 liberal lawmakers now say they will vote against any conference report that includes the provision. That's more than a big enough bloc to kill health care reform altogether. And on the other side of them are 64 Democrats who voted for the Stupak amendment, 40 of whom actually voted for the final bill on Saturday. Nancy Pelosi will have to get those numbers way down if she doesn't want the whole reform project to collapse in its final stretch. Stay tuned.
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vamonticello
November 9, 2009 7:19 PM
the problem started when the pro-choice democrats tried to sneak in a change of law that allowed federal money to be used for abortions. The stupak amendment tried to make a correction to that and the words he chose left things open to interpretation. Stupak was trying to apply the hyde amendment to this bill and THATS IT. Obama agrees that the language needs to be cleared up BUT he also agrees that federal money CANNOT be used for abortions....that is current law.
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FreeRider
November 9, 2009 8:10 PM in reply to vamonticello
Pro-choice democrats never tried to have federal funds used for abortion. That's an outright lie.
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Stroszek
November 9, 2009 8:56 PM in reply to FreeRider
Word.
The bill never directly financed abortions. The argument for Stupak, if taken to its logical extreme, would require us to cancel subsidies to all kinds of private companies.
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WillAct723
November 10, 2009 9:57 AM in reply to vamonticello
Not exactly. The Hyde amendment says that money from HHS cannot be used to cover abortions, but this is a common mistake.
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kash79
November 9, 2009 7:23 PM
The biggest news of the day on this one is Tapper's interview with the president. It shifts the momentum tremendously on the issue.
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oskieoskie
November 9, 2009 7:38 PM
Without this, the bill would not have passed. Pro-choice folks need to take a chill pill.
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kash79
November 9, 2009 7:41 PM in reply to oskieoskie
President, of course is the baby-sitter-in-chief.
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bluebell
November 9, 2009 7:54 PM in reply to oskieoskie
You don't get it. A bunch of Catholic clergy, all MEN, dictated healthcare to ALL American women.
Remember this insurance is not a choice. It is a mandate. We are being ordered to buy insurance that does not cover our healthcare needs. What will it be next? Will we be ordered to buy policies that deny stem cell transplants? The precedent is horrific. Republicans claim they don't want "government run" healthcare. Well I don't want the government making my healthcare choices for me either and treating me like a second class citizen who needs to have her health deterined by an all male clergy. Plus, this is all about political expediency. It has nothing whatever to do with what kind of healthcare women need.
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kash79
November 9, 2009 7:59 PM in reply to bluebell
While I don't support the Stupak Amendment, and would like to see the language scraped, I do think you are drawing sweeping and assertions.
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kash79
November 9, 2009 8:00 PM in reply to kash79
sweeping assumptions and assertions.
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bluebell
November 9, 2009 8:11 PM in reply to kash79
Don't worry about spelling. I never do. The precedent is horrible. The trap was set and the clueless, amoral, haven't seen a principle in decades, leadership fell right into it. What irony. The Republicans claim the bill dictates your healthcare choices and what do you know, it does.
Beyond abortion, it is wrong, wrong, wrong to force Americans to buy health insurance and then deny medical procedures based on political expediency choosing one set of religious beliefs over others.
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kash79
November 9, 2009 8:17 PM in reply to bluebell
Ah..I forgot you don't support the bill even without the Stupak amendment. GL
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bluebell
November 9, 2009 8:28 PM in reply to kash79
I have ZERO trust in the Democratic leadership and this is just one more example of why I don't trust them. Turn your back for one second and they've sold out a women's right to choose as if they were bartering a bridge in Alaska.
It's also an example of why the plea to open the big tent and embrace the pro-lifers is a fool's game. What do they do? They let the most important domestic bill in decades be held hostage by the bishops.
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kash79
November 9, 2009 8:44 PM in reply to bluebell
This is not over yet. I'm confident the final bill will not contain the stupak amendment even if it means further watering down the bill.
I'm not a big fan of the "leadership" (esp. Reid) either but I also understand the political process...I'm sure you do as well. The way the process it structured it is impossible to fully reform something as huge as healthcare from a "free market" corporate system to say single payer or even Medicare style PO. There are no votes for it, and a transformation will take more than a bill, a year or a president.
All big things that have happened in legislative history have happened in phases and even something as basic as civil rights have taken decades to process.
I join you in lamenting on the corporate dominated political system, but I also think any progress toward the "left" can only happen in steps. And I believe this is an important step.
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bluebell
November 9, 2009 9:03 PM in reply to kash79
I'd agree with you if I didn't believe there may be so many poison pills in the bill that it may turn out to be as much a step to the right as it is to the left. This abortion amendment is a case in point.
We did do Medicare. We could have taken steps to phase in an expansion of Medicare covering people over 60 or allowing people over 50 to buy in, etc. Then it would have been clear to Americans how they would benefit and what it would cost.
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kash79
November 9, 2009 9:09 PM in reply to bluebell
We could have taken steps to phase in an expansion of Medicare covering people over 60 or allowing people over 50 to buy in, etc.
I'm not sure that would have made not everyone on the left happy either and you know it. More importantly, even your suggested plan will leave many important issues un-addressed. There are some good things in this bill, I mean the House bill- of course fully excluding the Stupak amendment.
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kash79
November 9, 2009 9:10 PM in reply to kash79
I mean I know its not the best bill, but I think at some point in history after 60 years, we have to take the first step.
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again
November 9, 2009 9:10 PM in reply to bluebell
we achieved medicare with the ball-breaking texan crudeness of LBJ
the man was a piece of work
once in a lifetime
check out the robert caro bio of him - woof
But it was also a different era - we still had a sense of community
we still had the draft
we understood "pooling" and "community" in many senses
it wasn't that long after WWII
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kash79
November 9, 2009 9:11 PM in reply to again
good points.
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elle a
November 9, 2009 9:28 PM in reply to kash79
you're right. i tire of people, on the left and right, who imagine that bills can get passes by just ramming it through...that isnt how government works and it is not how a democracy works either.
i understand why they had to put the stupak amendment in there, but i do think it should be stripped out, because it specifically targets women who want abortions covered in their health insurance policies, from not getting any kind of government assistance which other women would get..thats a huge discriminative slap in the face
i'm sure there are other ways to word the amendment. even though i dont support it at all, i think its crapola of the highest level.
so some democrats wouldnt vote for the bill which stands to help millions of americans unless some section of women could be effectively discriminated against.
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again
November 9, 2009 9:35 PM in reply to elle a
I disagree - if you're getting in for regular GYN - which if you weren't covered you weren't getting before, then you have a very low chance of an unintended pregnancy.
Abortion is too important a right not to work to reduce its incidence, right?
I mean, the whole entire point from the perspective of the health care provider who actually wants reform is to provide a basic level of preventive care SO THAT we can avoid unnecessary surgical interventions.
Why shouldn't abortion follow that pattern?
Why infantilize women? We're more than capable of 1) preventing pregnancy through safe, effective and nearly fool-proof low-dose birth control, and/or 2) buying an additional rider.
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again
November 9, 2009 9:37 PM in reply to again
Sorry, what I meant in that first paragraph is that with the House bill, you'll finally be getting in for that regular GYN exam and thereby access to birth control. SO you're then significantly less likely to have an unintended pregnancy.
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AJM
November 9, 2009 10:33 PM in reply to again
It infantalizes women to have the government make decisions the individual should be making. This bill does that. However helpful the addition care plus the fine inherent in being forced to pay an additional cost for a separate policy to exercise a constitional right, the insult to women as moral beings is intolerable. Further, the establishment of a particular religious view violates the separation of church and state.
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slb
November 10, 2009 1:35 AM in reply to again
You are ignoring two things: first, that no birth control method is 100% effective. So there WILL be some proportion of unintended pregnancies no matter what kind of precautions are taken to avoid them. This would include pregnancies that result from rape. They are rare, but they happen.
Second, there are times that abortion is necessary to end an INTENDED pregnancy that has gone badly wrong. I think those should be paid for as any other medical procedure would be paid for.
I'm really tired of having right-wing moral concerns as the only ones that seem to matter to legislators. My tax dollars go to all kinds of things that I find morally reprehensible, including the taking of innocent life -- by predator drones, for example, or in subsidies to Israel which uses them to kill Palestinian children. But nobody gives me any way to opt out of that.
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slb
November 10, 2009 1:44 AM in reply to again
I can't imagine anyone opting for an additional rider specifically to cover abortion.
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AJM
November 9, 2009 10:27 PM in reply to kash79
It's big step backward in its current form.
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again
November 9, 2009 8:32 PM in reply to kash79
kash,
I have to agree with you on this one.
we can't kill the bill based on this -
and it's not at all clear to me how this actually changes the existing number of federal dollars provided for abortion
(Given the extremely low-dose oral contraceptives now available, it is difficult for me to imagine why we need to provide so much federal money for abortion, which at this point should generally (I said in general) be a superfluous procedure because of high quality birth control methods.)
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AJM
November 9, 2009 11:00 PM in reply to again
We certainly can kill the bill based on 'this'. This being that it treats a class of Americans as second class citizens. You'd kill it in a heartbeat if it required Catholics to buy a separate policy in order to obtain birth control because their religion objects to it.
But it's fine by you to require women to buy a separate policy to cover abortion because Catholic(and some others)dogma objects to it.
The point about choice is not whether or not you need to use it but that when a choice needs to be made, the individual gets to make it. The Stupak bill allows the government to penalize a certain choice.
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Observerinvancouver
November 9, 2009 10:49 PM in reply to kash79
But she hit the nail on the head: "Remember this insurance is not a choice. It is a mandate. We are being ordered to buy insurance that does not cover our healthcare needs." I betcha that the compulsory aspect is that will kill the Stupak amendement.
BTW (and haven't read whole thread), what impact would this amendment have on federal health care insurance? Do federal employees get abortion coverage now (paid for by their insurance companies through insurance premiums paid by the federal government)? If so, will that insurance coverage have to change? Are these pro Stupak Dems willing to do that? Are the women in their families?
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slb
November 10, 2009 1:38 AM in reply to bluebell
Rachel Maddow dedicated a couple of segments on her show to this issue tonight. It's not clear that it is actually Catholic clergy that is behind this amendment. Both Stupak and its Republican co-sponsor (whose name escapes me at the moment) are C-Streeters. So are at least 8 other Democrats who voted for the amendment (and subsequently voted against the bill).
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Kuyleh
November 9, 2009 10:14 PM in reply to oskieoskie
I'll chill when every ED drug is no longer covered as well. You want to shove your religious morals down my throat, fine. But be equal about it. If I can't have help paying for my reproductive issues, men shouldn't be able to either.
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AJM
November 9, 2009 10:25 PM in reply to oskieoskie
Like'em barefoot and pregnant?
Women have the right to make their own moral decisions and the government should not penalize those choices -- being required to purchase a supplemental is essentially a fine on a portion of a family's medical care on the basis of Catholic theology which privileges the life of a fetus above the life of a pregnant woman.
If you are willing to agree to so-called reform which makes a portion of the American population into second class citizens -- say white male Christians should be denied prostrate surgery because my religion demands that their seed is sacred and removing the diseased organ is essentially spilling their seed on the ground and hence a sin -- then, tell pro-choice folks to chill.
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Stroszek
November 9, 2009 11:57 PM in reply to AJM
Ah, so you have a huge problem with passing health care reform if it makes women into second class citizens... but you had no problem working to make women into second class citizens for the sole reason of seeing Obama defeated in the general election.
Your hypocrisy is stunning.
You and the other PUMAs sought to throw women under the bus for good for what? A substantive policy goal? No, just a deranged, personal vendetta. You have no ground to stand on, AJM. It's obvious to anyone with a memory that your hyperbolic bile has more to do with loyalty to your fringe, racist blog buddies than any serious moral considerations.
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NewsNag
November 10, 2009 12:30 AM in reply to Stroszek
Your misogyny is stunning. She's right. Women are not being respected, and their civil rights are being sacrificed. It is a dealbreaker. Shitty healthcare "reform" isn't worth the price of making misogyny "respectable".
Grow a pair, "man", and curb your gender bias.
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AJM
November 10, 2009 12:32 AM in reply to Stroszek
It's not hypocrisy and Strozel is not logical. Its a matter of weighing the relative importance of things. It is indeed an outrage when a woman's right to choose is impinged on but stopping the risk to all life posed by global climate is more important. I judged McCain better on the last than Obama and far worse on the second. It is a judgment about the relative importance.
Strozek can get back to me when Obama gets an effective plan against global climate changed passed.
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NewsNag
November 9, 2009 11:59 PM in reply to oskieoskie
Very omniscient of you to know what we should do. Oh, I think I'll be omniscient too: You are a man, and white, who cannot get pregnant, doesn't have any idea what it's like to be a minority, or what it's like to have your civil rights thrown under the bus politically, and have so little compassion to go with your lack of understanding, but have so much arrogance hard-wired into your privileged head, that you think you know what's best for millions upon millions of people. Chill, indeed. You think you have the only and the only and the perfect true understanding of what's going on and what needs to be done. I'm ashamed I read the same blog as you.
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Indie Pro
November 9, 2009 7:40 PM
here's a good write up of the amendment:
http://wonkroom.thinkprogress.org/2009/11/09/stupak-amendment-jessica
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Indie Pro
November 9, 2009 7:45 PM in reply to Indie Pro
the way leadership handled this also sucks. Progressives were told there could be no amendments. But then this. That was a big middle finger to the liberals.
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bluebell
November 9, 2009 7:58 PM in reply to Indie Pro
It was a big middle finger to women.
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Indie Pro
November 9, 2009 8:02 PM in reply to bluebell
yes!
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Schmed- ley
November 9, 2009 8:13 PM in reply to bluebell
It was a big pressed ham.
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AJM
November 9, 2009 10:36 PM in reply to Indie Pro
There was a vote on the house rule that allowed this amendment to come up. Who voted how on that is what I want to see. Or how it was accomplished. Dingell worked to get it done but then hid from his pro-choice district by voting against the Stupak Amendment itself.
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Willow
November 9, 2009 8:20 PM
Isn't this the problem with pretty much all legislation? No one actually knows what the hell it all means. It's basically Greek to 99% of Americans.
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Stroszek
November 9, 2009 8:27 PM in reply to Willow
DEATH PANELZ
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kash79
November 9, 2009 8:46 PM in reply to Stroszek
End of freedom
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AJM
November 9, 2009 10:39 PM in reply to kash79
If the pope could get pregnant, abortion would be a sacrament.
You try either carrying an unwanted pregnancy to term OR being an unwanted child, then you can joke about whether freedom is or is not involved.
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kash79
November 9, 2009 10:55 PM in reply to AJM
You try either carrying an unwanted pregnancy to term OR being an unwanted child, then you can joke about whether freedom is or is not involved
Your hyper temper is purely misplaced. I was replying to comment which said "Death Panels" suggesting "End of Freedom" which has been a standard republican line on the healthcare debate.
You're a hyperactive dimwit and I am sure it has nothing to do with you being a man or a woman.
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AJM
November 9, 2009 11:15 PM in reply to kash79
That you don't recognize that the limits placed on a woman's right to choose do in fact diminish freedom was my point.
You can't even imagine either state referenced enough to see why anyone who respects women as equals would be outraged by the Stupak amendment.
So you call a few cute names and feel so self-righteous.
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kash79
November 9, 2009 11:25 PM in reply to AJM
I was not cute or anything you were dumb to suggest
that I try either carrying an unwanted pregnancy to term OR being an unwanted child , which add does nothing but makes it rude and personal. Again, you're absolute lying or being too thick when you suggest that I don't recognize that the limits placed on a woman's right to choose do in fact diminish freedom You're lying or being dimwit.
Because I didn't say anything of sorts across the thread. If anything, I made it clear on one more than one occasion in the same thread I fully oppose Stupak amendment.
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Stroszek
November 9, 2009 11:47 PM in reply to AJM
Just so everyone's clear on AJM's position here:
Not killing health care because it prohibits abortion coverage in federally subsidized insurance plans = An Outrage
Facilitating McCain's efforts to completely overturn Roe v. Wade because you're mad your candidate lost the primaries = A Courageous, Progressive Stand
Could AJM's hypocrisy be any more absurd?
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AJM
November 10, 2009 12:28 AM in reply to Stroszek
Treating women as second class citizens is objectionable in any setting. If you can imagine Hillary allowing anything like the Stupak amendment in place let me know. So, yeah, Hillary would have been the better choice for women's rights.
That said, originally they appeared to be at relatively the same page on policy -- it was only when after examining his writing and records that it became clear that Obama was so interested in being loved by all that he was apt to sell his allies out in the interest of 'bi-partisanship'. Maybe this became clear to me be earlier than to most because of my preference but nothing in his record so far indicates that this assessment of him is wrong.
As I told Strozek elsewhere I voted for McCain in part because I believe that McCain would have in place by this point an effective anti-global warming plan and that Obama would not. That I recognized that McCain's plan would be based on nuclear energy which is not my preferred method but that the planet -- and all life on it -- would be saved. For me this issue trumps everything. Obama, on the other hand, would propose a perfectly wonderful plan and then, in the interest of placating everybody, settle for something so watered down that it wouldn't work. The cost was the McCain would be against my positions on approximately 95% of everything else.
I'd rather that Strozek replied to my arguments rather than continue to air his fervid fantasies of irrational male hating feminists or PUMA's either.
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again
November 9, 2009 8:40 PM in reply to Willow
It's apparently also Greek to 99 percent of actual legislators.
(BTW, in modern Greece, they don't say "it's all Greek to me" - they say "it's all Chinese to me.")
I believe the "it's all Greek" expression dates from the Roman era, when the aristocracy spoke Greek to distinguish themselves from plebes. Shakespeare uses an expression similar to "it's all Greek" in "Julius Caesar", having lifted much of the plot from Roman accounts that, like many Roman texts, were actually written in Greek.
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Dorn76
November 9, 2009 8:45 PM
That it is poorly written is just another reason it will be stripped out in an eventual conference.
The House bill is not the final bill. Settle down.
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Stroszek
November 9, 2009 8:53 PM in reply to Dorn76
We'll probably see a similar but less ambiguous amendment added to the Senate bill.
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again
November 9, 2009 9:15 PM in reply to Stroszek
I'd say you're on the money.
I'd further say that, given the fact that Stupak doesn't impact abortion in quite the way that my side is insisting it does, most Americans will be happy to trade off a percentage of federal funding for abortion if it means getting more women regular GYN exams - during which time they can get easy access to oral contraceptives - which are now extremely low-dose and breathtakingly effective.
Which would thereby drastically reduce the need for federal funding for abortion.
The fact that the lo-dose estrogen pill makes your periods less painful, and your skin clearer, is a pretty big incentive for women to use it IF IT'S AVAILABLE, which it will be.
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bluebell
November 9, 2009 9:22 PM in reply to again
Well, better speak softly or those bishops will be back. They believe contraception is as wrong as abortion you know.
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again
November 9, 2009 9:32 PM in reply to bluebell
I read the bishops' letter, it was, except for the abortion part, somewhat radical in its insistence on including immigrants.
But who listens to the bishops? Not Catholics who don't follow Catholic doctrine on anything. So I think we all know who the real anti-abortion forces in this country are. Baptists, born-agains,
It's not Catholics who are marching in the streets, if you haven't noticed.
It's Mormons with their bizarre anti-8 push, and fundamentalist born-again and baptists.
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bluebell
November 9, 2009 9:40 PM in reply to again
Rachel just had a very scary segment about the influence of The Family on the amendment. We live in scary times and we better start fighting back because they never stop fighting. We can't even win without losing.
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wendy davis
November 10, 2009 10:41 AM in reply to bluebell
I was going to post that Blue Dog 'Family' Dems also voted for the amendment.
It is just sick to assert that women can 'buy abortion insurance.' As though anyone plans on either accidentally getting pregnant, or finding themselves unable to carry a pregnancy to term.
Those hypocrites who don't want government to get between themselves and their doctors need to take a hard, cold, look at their dishonesty. Safe, legal abortion is the law of the land. Personally I want federal dollars to pay for abortions. Especially in this recession/really depression, unwanted pregnancies could be disatrous. And this IS a big deal; look at what some Senators are saying already about it!
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AJM
November 9, 2009 10:41 PM in reply to again
Politicians listen to Bishops, or hadn't you noticed?
It helps if you have a tax free pulpit from which to activate your members each Sunday.
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nosyte
November 9, 2009 8:50 PM
Someone should point out that insurers would normally have every incentive to cover abortions. Abortions are much cheaper for the insurer than full-term pregnancies and deliveries. Therefore, rather than charging more for abortion coverage through some sort of rider policy, insurers should give a rebate to women who sign up for abortion coverage in their policies.
Someone should point this out... Where is that health insurance lobbyist when you need her?
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again
November 9, 2009 9:08 PM in reply to nosyte
holy bat guano
you, sir, are a genius
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VivaAmerica!
November 9, 2009 9:18 PM in reply to nosyte
or you could tell your rep/senator in congress.
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again
November 9, 2009 9:18 PM
I found that this NPR segment was more clear than this particular TPM post.
(Though I am a big TPM fan.)
http://www.npr.org/templates/story/story.php?storyId=120251035
Transcript follows:
"November 9, 2009: 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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kash79
November 9, 2009 9:27 PM in reply to again
Thank you so much. Everyone should listen to it. NPR Rocks!!!
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lifeofreilly
November 9, 2009 9:53 PM in reply to again
So if I get a tax credit for 20% of my premiums (say, $50 a month), meaning I am paying 80% (say, $200), I would still have to buy the supplemental policy for full reproductive insurance?
That seems downright discriminatory to me. I am paying $200 a month. And I can't get insurance coverage I would consider BASIC without buying a piggyback policy? (This presumes that I know all the coverage details, and also foresee that I might need abortion services someday.)
There has to be a fairer way to do this. Those who don't approve of abortion should have access to a policy that doesn't provide it, and those who pay any funds at all (or meet a certain payment threshold) should be able to enroll in a "pro-choice policy" without buying additional coverage. The insurance companies on the exchanges should be able to aggregate money that we participants contribute ourselves into a "pool" that is available for abortion services.
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xargaw
November 9, 2009 9:34 PM
If the spirit of this amendment is allowed to prevail, the Democratic Party will be dead to women across America. Sure, they won't join the GOP, but they won't DEM either. This is the dumbest turn of events in decades by the DEMs.
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again
November 9, 2009 9:40 PM in reply to xargaw
Not to this woman.
To me, getting people treatment for life-threatening illnesses like cancer, TB, et cetera is a lot more important than federal funding for abortion.
That doesn't mean I don't support a woman's right to choose.
It does mean I have a real hope that we'll reduce the overall number of abortions through regular GYN visits.
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tammanycall
November 9, 2009 10:03 PM in reply to again
Well, this woman would. If Stupak is in the final bill, the Democrats are dead to me. No more money, no more canvassing, and they can kiss my vote goodbye. I won't support candidates who think my rights are negotiable.
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AJM
November 9, 2009 11:04 PM in reply to tammanycall
I've worked hard for Democrats in the past. I voted against Obama in part because I believed he would cave on choice. I have informed my reps that I will vote against any who vote for any version of the bill with Stupak in it.
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again
November 9, 2009 11:26 PM in reply to AJM
I'm no big defender of Obama, as everyone here can attest to. But it's not clear to me that Obama has "caved" on choice. Did Obama bring forward the Stupak amendment? Did Obama vote on the Stupak amendment?
Marcy Kaptur supported the Stupak amendment. That's what we're dealing with - even people who are solidly progressive supported this.
Again, the ultimate goal of health care reform is to provide for everyone by reducing the need for unnecessary procedures. With proper planning, abortion will become for many an unnecessary procedure, just like Diabetes Type II should be. For this, we should all be grateful.
Do I like the Stupak amendment?
No. But someone needs to show me the numbers for how this will actually affect the provision of abortion.
I seems from the NPR piece that this will not affect Medicaid spending on abortion, and that may be the most relevant aspect for low-income women. Here's the money quote.
"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."
My biggest question is: how will this change the existing funding?
And no one seems able to provide the numbers.
I fully believe that the preservation of abortion rights depends on our taking a mature view of the responsibilities that should attend those rights. This country is out of control with a number of procedures that could be easily prevented - abortion is just one of them. This attitude (toward more than just abortion) has been a major component of health care inflation.
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Stroszek
November 9, 2009 11:35 PM in reply to again
FYI, you're speaking with a PUMA who supported McCain/Palin. That being the case, the sincerity of AJM's indignation here is, to say the least, questionable, and AJM's attempts to tie this back to Obama has less to do with reality than the demented, irrational hatred of the man that characterizes all PUMAs.
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AJM
November 10, 2009 12:51 AM in reply to again
Obama is in the position of the man behind the curtain in the OZ tales. So, yeah, the buck stops with him the last I heard.
We don't seem to have watched the same video of Obama praising the House for passing the thing. Took him quite some time to make it clear that he was now opposing the Stupak Amendment. How much credit am I supposed to give him when he only protects choice after an uproar?
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Stroszek
November 9, 2009 11:32 PM in reply to AJM
Nah, you and the other PUMAs voted against Obama because you feel an irrational hatred for him. If you actually cared about choice, you wouldn't have backed McCain and attempted to pave the way for another anti-choice justice on the Supreme Court.
Your hypocrisy is amusing though.
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Beagle
November 9, 2009 9:57 PM
Surprise surprise. Stupak was (not sure if still is) a C-Street resident.
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ericf
November 10, 2009 1:16 AM in reply to Beagle
Please tell us he's also facing a primary challenge. How conservative is his district?
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slb
November 10, 2009 2:20 AM in reply to Beagle
So are at least 8 other Democrats who voted for the amendment, according to Rachel Maddow.
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markg8
November 9, 2009 9:57 PM
This is an awful amendment and just plain stupid politics. We were told all summer long any amendment along these lines wouldn't change existing law. If Clair McKaskill who is making noises about accepting language like this in the senate bill thinks this is going to fool abortion opponents into voting for her she's dead wrong. If it's a fig leaf for anti-choice Dems to tell the rabid religious right in their districts "we tried" before it's stripped out it won't work either.
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manyamile
November 9, 2009 10:17 PM
1.education and contraception( for women/couples who want to prevent/delay pregnancy) is most cost effective
2.in cases where contraception fails, abortion, especially first trimester, is still less expensive , medically , than preand post natal care, delivery, and childrearing.
3.I think education and gyn care reduces costs, reduces # of unwanted pregnancies, encourages and allows earlier decisions regarding pregnancy,(fewer late term abortions)..and of course provides care for women who choose childbirth.
This is one area where insurers , healthcare professionals and rational women agree.
so how did this get so far off track?
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bluebell
November 9, 2009 10:23 PM in reply to manyamile
Insurers, healthcare professionals and rational women weren't in the smoke filled room. That room was reserved for the clergy.
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Steve LaBonne
November 9, 2009 10:55 PM
All this mishegoss could have been avoided by doing an incremental expansion of Medicare- a highly popular program- instead of this Rube Goldberg contraption to funnel even more money to the insurance parasites. Many people tried to tell the Democrats this. Now they're getting just what they deserve for their flagrant stupidity.
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kash79
November 9, 2009 11:07 PM in reply to Steve LaBonne
That would absolutely not get 218 votes in the House or even 51 votes in the Senate.
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Steve LaBonne
November 10, 2009 6:48 AM in reply to kash79
I'm talking about a seemingly modest incremental approach that would ultimately revolutionize the system but only down the road- kind of the way Social Security was a mere shell initially, that wasn't really filled in till the 50s. Extend to age 55 as the first step, on a buy-in basis rather than as an entitlement. I guarantee you that would have gotten MORE votes than this mess. It also would have proved enormously popular and pressure to extend further would have built within a few years of passage.
If this piece of crap fails- as I frankly hope it does- that will be the way to go.
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Stroszek
November 9, 2009 11:12 PM in reply to Steve LaBonne
Medicare would be subject to the Hyde Amendment, so even if you could get the Blue Dogs on board for it, abortion coverage would be strictly prohibited without even having to introduce an amendment.
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Steve LaBonne
November 10, 2009 6:43 AM in reply to Stroszek
Hyde Amendment language also was already included in both (pre-Stupak) House and Senate drafts. Stupak != Hyde; it goes way beyond Hyde, as the President himself has pointed out.
So your comment makes no sense.
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Dunvegan
November 10, 2009 12:11 AM
Tie the Stupak Amendment to Viagra.
No reproductive care? No coverage whatsoever for Viagra.
That will end this among the Republicans, period.
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AJM
November 10, 2009 12:39 AM in reply to Dunvegan
Don't expect Stroszek to laugh. He has no sense of humor.
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AJM
November 10, 2009 12:41 AM in reply to Dunvegan
Don't expect Stroszek to laugh. He has no sense of humor.
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johnnyba
November 10, 2009 8:03 AM
hah, So what did people expect?
Sheesh, someone above said it was "ironic" to get this inserted after all the conservative screaming about choice. No, its just that you weren't paying attention. That's how they operate so its what they assume will be done.
Wait until you get another very conservative president and/or congress and the talk about death panels begins in earnest.
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AnitaBee
November 10, 2009 8:18 AM
This hyperventilating about the Stupak amendment is much ado about nothing.
Women who get subsidized care now can't get funding for abortions. Women who get subsidized care under the Stupak amendment won't get funding for abortions.
In other words, nothing changes.
Likewise, women who now pay for their own insurance may or may not have the opportunity to buy a policy with abortion coverage. It depends on what's available in their area, and what level of coverage they choose to pay for.
Women who pay for their own insurance through the exchanges may or may not have the opportunity to buy a policy with abortion coverage. It depends on what's available in their area and what level of coverage they choose to pay for, by buying supplemental insurance.
All that changes with the Stupak amendment in the bill is that, because more women will qualify for subsidies, those women, should they choose to have abortion coverage, will have to buy it separately.
Instead of focusing on a non-issue like this, we should focus on getting a bill passed. We'll STILL get all the other benefits of passing health care reform: the end of rescissions, the end of denials for pre-existing conditions, the end of annual and lifetime caps, subsidies for those who currently can't afford insurance.
Now, let's go get those dumbass six senators onboard.
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Steve LaBonne
November 10, 2009 8:32 AM in reply to AnitaBee
You're wrong: http://www.motherjones.com/politics/2009/11/price-health-reform-abortion-rights
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AnitaBee
November 10, 2009 10:18 AM in reply to Steve LaBonne
Actually, the link you posted says precisely what I said.The only difference is that the Mother Jones piece makes the Stupak amendment sound cataclysmic and I wrote that it's much ado about nothing. The MJ piece and my post agree on its effect.
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again
November 10, 2009 1:37 PM in reply to AnitaBee
I agree, except you need to consider that the House Bill even with Stupak may actually increase access to publicly funded abortions through Medicaid.
While ironically decreasing the demand for abortion by providing higher access to birth control through exhanges and the public option and expanded Medicaid rolls.
It's a win-win, except for people who can't read.
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AnitaBee
November 10, 2009 2:00 PM in reply to again
Yes, agreed. What this looks like to me is the progressive "tea party" over-reaction to a provision that a special interest on the progressive side doesn't like. Its actual effect will be minimal to non-existent because it only affects women who get subsidized policies. And many if not most of those women don't have ANY insurance now.
So, what then? We'd rather that they continued to have NO insurance than to give them access to medical care for whatever else might threaten their health or their lives?
If we reject reform all together because of this red herring, here's where we end up:
- Business as usual for insurance companies.
- Rejections for pre-existing conditions.
- Rescission of existing policies when a person gets sick.
- Continuation of annual caps, lifetime caps, exclusions.
- Those who can't get policies due to pre-existing conditions limited to over-priced junk insurance -- if they can afford it -- that covers little or nothing.
In other words, nothing will change because the progressive version of the tea-partier got out his/her pitchfork over a theoretical rather than an actual problem.
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Obama1st
November 10, 2009 8:57 AM
Women are not second class citizens and the decision is properly in the hands of women and their doctors. A legal procedure left to politicians is horrid policy and the dems will be suffering for this amendment.
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again
November 10, 2009 4:01 PM in reply to Obama1st
Except for the fact that this does nothing to affect the legality of abortion.
If Dems suffer, it will be because some people can't read what's actually in the amendment or in the House bill.
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DKDC
November 10, 2009 5:02 PM
I am amazed by the amount of reasonable and thoughtful reactions on this topic here - the effects of the Stupak amendment are being vastly overrated.
Just another thought to add to the mix amidst all the hyperventilating - right now at this very minute, insurance "coverage for" abortions does not necessarly mean medical "access to" abortions, so to equate the amendment's provisions on coverage to taking away access is a stretch at best. Go right now to the hospital or primary care physician's office you would normally go to and ask them if they perform abortions - then ask your private insurance company if they'll pony up for an elective abortion at the place those hospitals and clinics most probably will refer you to. The findings might surprise you.
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