The Stupak amendment has touched off a furious argument among Democratic politicians and elites--one that could tank the entire health care reform project if it's not resolved by the time legislation comes up for a final vote in the House.
For the most part, the argument has been about justice. The Stupak amendment would forbid anybody who receives new government health insurance subsidies from buying policies that cover abortion. So why should women's health care be treated differently than other kinds of health care? Is it fair to prevent women, forced into the health care market, from buying any insurance policy she wants, even if they have some government assistance?
But somewhat less prominently, these same combatants have been at odds about what the practical effect of the Stupak amendment would actually be. There's substantial lack of clarity on that score--many say it's likely that there will be no abortion coverage in the exchange at all, and others hypothesize that, over time, the norms in the exchange will come to dominate the norms across the insurance market. At this point, that's all theoretical. But there is at least some data on the immediate practical implications of the Stupak amendment: It will, at least, directly and immediately impact a small, but growing number of poor and middle-class women.
The least-impacted women will be those whose employers (or whose spouses' employers) provide them insurance. In 2013, that will be 88.5 percent of privately insured people (162 million) who will, for the most part, keep the plans they have. The data regarding women with employer-provided health care is very mixed. According to the Guttmacher Institute, in 2002, 87 percent of employer policies covered abortion. But according to the Kaiser Family Foundation, that same number in 2003 was 46 percent. A substantial difference.
Acknowledging the wide chasm, Guttmacher concluded that "The actual answer is probably somewhere in between, meaning that most Americans [tens of millions] with employer-based insurance currently have coverage for abortion." Guttmacher also said that the overwhelming majority of plans that do cover abortion, will pay for them in almost all cases (i.e. not just in cases of rape, incest, and threat to the life of the mother).
Despite this, the Institute found that most women nonetheless pay for abortions out of pocket. Only 13 percent of abortions in 2001 were paid for by insurance companies. But, they note, this number is skewed downward for a number of reasons. For instance, many women who have abortions don't have any insurance to begin with, and many of those who do have insurance aren't aware that their policies cover abortion. These distortions are supposed to be rectified by comprehensive health care reform.
Stupak won't effect these women at all, at least not immediately, and the greater reform package could actually make abortion a less complicated medical issue for them.
Overwhelmingly, the women effected by the law will be in the insurance exchange.
"Obviously the direct impact of Stupak only applies to the exchange...so it depends how big that gets," says Adam Sonfield, Senior Public Policy Associate at Guttmacher.
The exchange will be much smaller than will the employer market. In fact, the number of women in the exchange will likely be lower than the number of women with abortion coverage in their employer-provided insurance. But under the terms of the Stupak amendment, the percentage of women in the exchange who will have abortion coverage as part of their policies will be tiny, or perhaps non-existent. "I think it's pretty safe to say..that it will effect all 21 million in the exchange," Sonfield says.
Of the 21 million people in the exchanges, 86 percent are expected to be receiving direct federal subsidies. It would be an oversimplification to say that this means 86 percent of women in the exchanges would be blocked from insurance coverage that includes abortion (it will almost certainly be more than that). But it is safe to say that the vast majority of, if not all, women in the exchanges will not be allowed to have abortion coverage in their benefits packages. These will be almost exclusively poor and middle-class women.
And their ranks are likely to grow. Over time, the reform packages under consideration allow ever larger employers to participate in the exchange, which will happen if the exchange keeps premiums down. "As employers go into the exchange over time...more and more women will be subject to these new rules," says Jessica Arons, who directs the Women's Health and Rights Program at the Center for American Progress.
"Coming from an employer plan that's likely to cover abortion...they're going to be losing coverage going into the exchange, either because they'll need an affordability credit, or because there'll be such a disincentive to cover abortion that insurance companies won't do it," Arons adds.
What does this mean for the number of abortions financed by insurance? As noted above, Guttmacher concluded that only 13 percent of all abortions in 2001 were paid for by private insurers. In theory, by increasing coverage, and transparency, health care reform should increase that number. But though the number of insurance-funded abortions will likely grow, the impact of the Stupak amendment would likely be to tamp down on that growth significantly.
What conclusions to draw from this? The uncertainties are substantial, but it's safe to say that, initially, a minority of women, and a minority of abortions will be impacted by the Stupak amendment. Those women will be very disproportionately poor and middle-class. And their ranks will grow as the exchanges open to larger businesses and a greater percentage of the population.

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mcc
November 12, 2009 3:05 PM
One thing I think has received not enough attention is that this would not only impact persons with individual coverage, but also persons who work at small businesses, since small businesses in the exchange will also be eligible for insurance credits.
This is interesting to me because although people buying insurance as individuals could avoid the Stupak amendment by simply not accepting the federal subsidies (assuming anyone in a position to qualify for the subsidies is in a place to make such a decision), persons working at small businesses may not be given a choice as to whether their employer accepts the poisoned subsidies or not.
I also wonder whether the conditions attached to the federal help might discourage some small businesses from participating in the subsidy/credit program altogether, creating a situation where the government is literally bribing some small businesses to not offer abortion insurance coverage to their employees.
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Indie Pro
November 12, 2009 3:32 PM in reply to mcc
what'll be interesting is seeing whether the effort to get party members (and activist groups) to shut up and go along with Stupak is successful.
E.J. Dionne: Democrats should ‘learn to live’ with leaving women behind on health care.
http://thinkprogress.org/2009/11/12/dionne-health-stupak/
HCR could shape up to be quite a wedge between people vs the party and activist groups they once thought were on their side.
I think the Dem party has been somewhat successful in passing off an ineffectual public option in the House bill as a win. Atleast many activist groups are now saying that, to the dismay of many of the people in those groups.
Will there be an affect on voter turnout in the near future, or the long term identity of the democratic party?
Interesting times. Not a blessing.
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VictorLH
November 12, 2009 3:41 PM in reply to Indie Pro
I for one will not accept leaving women behind when it comes to them having a constitutional right to such medical care. As for this bill, it is a piece of crap and I am close to leaving the Democratic Party at the National level over this as well as the many other betrayals by the Corporate controlled Democratic party. Yea,Obama - this is change we can beleive in. The Bill should be titled the For Profit Health Insurance Industry Protection Act.
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TaraV
November 12, 2009 3:59 PM in reply to VictorLH
Here's what I don't get from people like you. This bill, in its current form, has been further than this country has even gotten on HCR. This is progresss. And yet, if it has elements of corporate interests, who we have to have not totally and completely against us lest it fail all together, it's not enough? Obama is a sellout? I realize it may not be ideal...in fact, I know it's not. Single payer is clearly the most efficient way to deliver healthcare. But you what, we're not going to get it. It's just not in the cards.
So while I realize there are corporate interests at play here, I'm not going to pack up my toys and go home because we are only making incremental progress.
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VictorLH
November 12, 2009 4:16 PM in reply to TaraV
I wasn't even considering Single Payer since it was taken off the table before the discussions even began. The point is, there is no Public Option in the sense that anyone can buy into it, yet there is a mandate to purchase insurance. What is there for the unemployed who will have to purchase insurance? Nothing that I can see, worse what if one is fired they have no uemployment then. Tell me what people are going to pay for insurance with when they can't do so now? What I find incomprehensible is how people like you can accept this as any sort of reform? Where did that campaign promise from Obama go where he said he wouldn't mandate insurance? Change We Can Beleive In, just like his flip flop on FISA.
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Indie Pro
November 12, 2009 4:23 PM in reply to VictorLH
What? Just because the insurance industry has circulated a few reports showing how everyone's premiums will be going up because of HCR doesn't mean they are gonna do it.
Why would they jack up everyone's premiums? Surely there are cost controls in HCR, since there is a mandate. Surely there are regulations in place to guard against that.
Come on, it's the Affordable Health Care Act. Surely, it'll be affordable. It's in the name afterall!
Besides the $30 billion dollars the CBO says the govt will get from penalties from the uninsured, that'll go back, or something. Hey! We'll get to that later. Meh, this is all small stuff.
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Indie Pro
November 12, 2009 4:26 PM in reply to Indie Pro
from now on, I'm joining the democrats and saying
whatever. just call it healthcare reform.
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JadeZ
November 12, 2009 4:36 PM in reply to TaraV
I see your argument all the time.
Yet you fail to explain why the democrats can't pass a good bill when they control congress.
And you acknowledge the bills weakness.
You argue that this issue will be revisited and this is progress.
It wont be revisited and tell me what is the progress?
Perhaps your naivety extends to the drug companies and the deals Obama cut with them.
And maybe your interests are compatible with mandated coverage that gives the insurance companies 40 million new "customers" while offering no competition to their profits.
So while every industrial country in the world makes sure its citizens receive not for profit health care you accept the death of children as an incremental step towards some far horizon of ...what??
If Obama had no intention of fighting for a single payer system because it could not be passed then he should never have taken on this issue without knowing and fighting for a robust PO that could be passed.
That was the compromise!
But I predicted months ago this bill would amount to nothing.
Because it was clear to me then and maybe others are waking up to the reality that Obama never intended real reform.
So while you may be content with calling anything (good enough) reform there are a few of us left that can no longer be fooled.
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TaraV
November 12, 2009 4:47 PM in reply to JadeZ
Yeah, you're right. Ending pre-existing condition denials, rescissions and life-time caps are nothing...won't affect anyone. Nor those subisidies for people who will now be able to afford it.
Look, Obama never stated he was in favor of single payer for this country so no he never had any intention of fighting for it. And it's not some ambiguous argument to state that we can't get anything stronger through even having a Dem majority. The proof is abundant.
Sausage making ain't pretty and I may not be in love with the end result but i can say that it's better than what we've got now.
So you don't like the Dem party caving to special interests and centrists? Fine, go out and do your thing to change the system but abandoning this process because it's not perfect is cutting off your nose to spite your face.
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Indie Pro
November 12, 2009 5:00 PM in reply to TaraV
right on. everyone qualifies for subsidies and subsidies will cover the full cost of insurance and everyone will be able to afford their premiums. No one will ever have trouble with copays either. It's not like premiums are gonna get more expensive.
I bet the insurance industry is shaking in their boots at the prospect of the mandates (you know, because with mandates, you have to end pre-existing condition denials and rescissions).
I'm surprised AHIP isn't fighting against subsidies, mandates, ending pre-existing conditions denials and recission. What are they fools? Spending all their time fighting a PO. Idiots!
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prairiesage
November 13, 2009 11:48 AM in reply to TaraV
TaraV you are mistaken when you say that Obama never stated he was in favor for single payer for this country. He stated it in 2003:
“I happen to be a proponent of a single payer universal health care program.” (applause) “I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its Gross National Product on health care cannot provide basic health insurance to everybody. And that’s what Jim is talking about when he says everybody in, nobody out. A single payer health care plan, a universal health care plan. And that’s what I’d like to see. But as all of you know, we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House.”
Obama speaking to the Illinois AFL-CIO, June 30, 2003.
http://www.youtube.com/watch?v=fpAyan1fXCE
Well we got the Whitehouse, the senate and the house and single payer didn't even get on the table.
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Cal Damage
November 12, 2009 10:27 PM in reply to JadeZ
I see the problem. It's in the word 'control.' You assume both parties are the same, and so the word must mean the same in the case of 'control' by either party. This is incorrect.
In the usual meaning of the word in this situation, 'control' means setting the issue agenda (healthcare for all as opposed to taxcuts for billionaires, for instance.) It also means the chairmanship of all committees, and usually a majority on each committee somewhat proportionate to the margin the majority holds.
Oh, and they get to pick who gets the best offices.
This has been the standard meaning for centuries of work at the Capitol. And, barring a strong personality (LBJ, Tip O'Neill) that is the limit of it
However, start with Newt Gingrich's election to the House, the GOP developed a new meaning, and the weapons (a word I do not use lightly) to enforce it. On the GOP side, if you voted against your leadership, your office got moved, or your earmarks mysteriously disappeared from budget bills, or you lost your chairmanship. (Remember, Newt replaced the chairmanship seniority system with the 'if you kiss my ass, you're chairman' method of selection. Look it up.) The minority (and then Majority) leader's office even issued fines to any member who did not refer to the opposition as the Democrat party, who was seen at dinner with one, who went to the gym or the dining room with one. They eventually built their own gym, and restaurants, and required all Republicans to sweat and eat where told to...sound like a command-and-control system the GOP claims to hate?
That's the meaning of 'control' you were using. Is that the way you want to run the country, mein commandant?
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bluebell
November 12, 2009 6:20 PM in reply to TaraV
That remains to be seen. People are taking this bill on faith but we won't know till it emerges from conference, if it ever does, just how bad it is going to be.
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castanea
November 12, 2009 10:07 PM in reply to TaraV
I agree. I already knew that the rightwing was nuts. The health care reform debate has proven that there are more than a few on the left who are irrational as well.
A woman will still have the right to choose, and that is what is important.
Two things leap out at me from the Stupak amendment debate. First is the claim that somehow women are being left behind by the current HCR, when in reality EVERYONE is being left behind if HCR does not pass. And what of women who are anti-choice and support the amendment? Are they too stupid to know that they are being "left behind"?
Second, in all the screeching done by bloggers and others about back-alley abortions and wire hanger and such, I've not read one person who has promised that, if abortion is not covered by eventual health care legislation, s/he will start, say, a non-profit to ensure that any woman who wants an abortion can get one. Instead all I've read from some on the left is that keeping abortion legal is not enough--that a woman who wants to terminate a healthy fetus that poses no risk to her own health must be subsidized.
I've read comments suggesting that because the American public is in favor of the public option in particular, and health care in general, that the various congresspeople and senators should vote in accordance with the public's wishes. Fair enough, but I also wonder if the public were to be polled on whether or not abortion should be included in HCR, and the results were that a majority of Americans said No, whether we'd get the same consistency from some "progressives."
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kenga
November 13, 2009 10:37 AM in reply to castanea
It's probably similar to what I've heard from other folks who insist that women in the midst of an un-wanted pregnancy must be required, and forced if necessary, to carry it to term regardless of the impact on their health, careers, and lives, or on that of the potential child.
I can respect the concern for "life" to an extent, though I don't see much consistency and very little support for the born.
I could live with the Stupak Amendment, so long as there's another amendment(call it the GFY Amendment) which provides that:
- ALL policies and providers are required to FULLY cover any and all forms of contraception desired by any woman over the lowest age of consent in the US, and any woman younger than that if a parent or guardian requests it or supports the woman's request with provisions whereby the woman has another means if a parent or guardian doesn't support the request,
- the act of, or attempt to deny access to said contraception, including Plan B, be criminalized and the mandatory civil penalties include loss of license to practice medicine, dispense medicine, and underwrite insurance, in addition to fines and jail time (I'd like to see advocacy of denying contraception criminalized too, but, Amendment I.)
- families that engage in "Purity" pledges or other similar ceremonies with minor children be required to be regularly interviewed by psychology professionals to ensure that the children are not being abused and provide counseling to parents with unhealthy obsessions concerning their childrens' genitals
- all children be regularly screened for signs of abuse
It needs more, but I think that's a decent start, particularly the first two. The other two are very important to incorporate as well - if only to provide something particularly onerous to hard-core social conservatives which if necessary can be use to bargain, to preserve the first two elements.
If the over-arching concern is preserving life, there should be no issues with taking every possible step to prevent un-wanted pregnancies. I think we can all agree that the best way to prevent abortions is to prevent pregnancies that are: un-wanted, a health hazard to mother or fetus, or resulting in severe or terminal genetic defects.
If the real issue is keeping control over the vajayjay and punishing sexual activity, well, GFY.
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sandi
November 12, 2009 4:22 PM in reply to mcc
I have a rule of thumb when assessing anti-choice legislation: the consequences will be broader than you think*. The authors have the goal of ending all abortion, and will exploit as many avenues as possible.
So I am very fearful that honest assessors like Brian are not cynical & fearful enough when predicting the outcome.
*For example, measures to limit teens' access creates additional legal risk for doctors. This pushes providers out and results in reduced access for all women.
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slb
November 12, 2009 5:43 PM in reply to sandi
I am in agreement with your assessment. Abortion opponents will push this provision as far as they can take it, and they'll probably be successful in pushing it pretty far.
I think at this point, I'm thinking that the next generation of women are going to have to fight their own battle over this. Mine and earlier ones fought ours, we gained a beachead, and the generation behind us has not been terribly interested in maintaining it. So I'm pretty much ready to say, "OK, go ahead. If you regret it later, you'll just have to start the fight all over from scratch. I'm not going to wear myself out trying to maintain rights too many others seem hell bent to trade away."
That does not make me any happier with the current Democratic Party. I came close to sitting out this year's gubernatorial election. As it was, I went to considerable trouble to get to the polls even though I knew it wasn't likely to make any difference to the outcome. Not sure I'll do that again.
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flufferwink
November 12, 2009 3:11 PM
Your second to last paragraph is wrong. Actually, the 13% statistic includes women on Medicaid. Without that inclusion, the number would be much higher. Here's the direct quote from Guttmacher about direct billing to private insurers for abortion services:
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TaraV
November 12, 2009 3:20 PM
Does the ammendment provide for any exceptions? So a woman insured via the exchange is told by her doctor that continuing her pregnancy will very likely result in her death. Or the baby is so severely malformed that it will die immediately upon birth. And this woman would have to pay for her own abortion?? ...her own MEDICAL treatment? Lovely.
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VictorLH
November 12, 2009 3:29 PM in reply to TaraV
Sort of defeats the purpose of Health Insurance doesn't it.
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jsfox
November 12, 2009 3:52 PM in reply to TaraV
The Stupak amendment allows abortions to be covered in cases of rape, incest and the health of the mother.
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KarenJG
November 13, 2009 11:49 AM in reply to jsfox
No, it only covers abortions necessary to preserve the life of the mother, not the health.
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slb
November 12, 2009 5:36 PM in reply to TaraV
As I understand it, coverage of the first case would be allowed, but not the second.
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VictorLH
November 12, 2009 3:31 PM
Democrats should make certain this hateful creep is primaried and defeated no matter what.
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slb
November 12, 2009 5:54 PM in reply to VictorLH
Stupak would not have been able to insert the amendment if there hadn't been 40-odd other Democrats that went along with it. And Pelosi would never have allowed it to be introduced if she had thought she could get the bill passed without it. And who knows -- maybe if Obama had leaned on a few people, she wouldn't have needed it. I saw something yesterday that estimated that the amendment only resulted in a net gain of 6 votes for the bill. It wouldn't have taken but turning a few of those around to have made the amendment unnecessary.
So I'm not so sure it's really Stupak you should be going after. It's those other Democrats. Maybe even Obama himself.
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John Hamilton Farr
November 12, 2009 3:45 PM
I am loving this mess! Anything anyone can do to scuttle the Insurance Company Enrichment Act is okay by me. If you're progressive and see the bill as something good, you're not going for the gold.
Kill the bill and give us Medicare for all. We are so far past the time for incrementalism.
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TaraV
November 12, 2009 4:02 PM in reply to John Hamilton Farr
What world do you live in? We can barely get this through and somehow you think we can get through single payer?!?! Yeah, just give up all the ground we've gained because it's not perfect. That'll work.
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VictorLH
November 12, 2009 4:20 PM in reply to TaraV
What you don't understand is we have not gained any ground at all. If this piece of crap passes the Democratic Party is dead. People are hurting now and when they see they have to buy insurance from for the for profit health care industry and premiums continue to rise they will hang us all.
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TaraV
November 12, 2009 4:40 PM in reply to VictorLH
The vast majority of people have very clearly stated that they want their for-profit insurance. This gives people subsidies to by into a system that most people claim they like. Yes, it's twisted but people don't like too much change...they really don't. This bill ends pre-existing conditions, life-time caps and rescissions. Doesn't sound like nothing to me. It's going to have to be tinkered with as time goes on but it's a step in the right direction.
Note that my first choice is single payer. I just realize that there is no way in hell that will get through.
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lifeofreilly
November 12, 2009 3:57 PM
This article doesn't address the fact that women who are NOT receiving federal subsidies and who participate in the exchanges would need to buy ADDITIONAL coverage for abortion services, on top of the basic policies available to all. And this would also apply to women who receive partial subsidies (say, they pay $300 per month and get $50 in subsidies).
Seems like a BIG change in how insurance for women's reproductive health is purchased and provided - forcing all women on the exchanges, rich and poor, to decide IN ADVANCE whether they think they might need coverage for these unexpected situations.
Another wrinkle here is that it's probably cheaper for insurance companies to offer abortion coverage, since childbirth can be so expensive. So we'd be asking women to pay EXTRA for something that could actually REDUCE the costs they represent to an insurer.
Sorry about all the capping. This issue gets me going. These are big changes that we shouldn't whitewash.
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Aloisius
November 12, 2009 4:28 PM in reply to lifeofreilly
Yes, but given the cost of abortions ($200-$600 I believe), the cost of coverage can't possibly be more than a few dollars a month.
Don't get me wrong, it is a negative that this thing is in there, but let's not pretend like coverage for a relatively inexpensive procedure is going to be a huge burden.
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Indie Pro
November 12, 2009 4:48 PM in reply to Aloisius
exactly, and poor people, who might say that amount of money is alot, screw'em. Let'em have more and more kids. That can only be a plus for an undercrowded world, and a system with plenty of room for more poor. Whatever. Just call it healthcare reform.
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JadeZ
November 12, 2009 5:02 PM in reply to Aloisius
lets just make 1 out of every 1000 blacks a slave.
lets not pretend thats a huge burden.
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Indie Pro
November 12, 2009 5:08 PM in reply to JadeZ
Hey. I bet we could bring some Southern Republicans onboard with that. Now that's thinking.
Repeal some child labor laws while we're at, oh or deny women the right to vote, but only in federal elections (let's not go too far). Now we'll get HCR for sure!
reductio ad absurdum is hard.
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sandi
November 12, 2009 6:02 PM in reply to lifeofreilly
My guess is that there are other gotchas, too. Like denying hospitals that provide abortions from access to any insurance patient. It is the old "money is fungible" arguement that supporting one part supports the rest.
And I am skeptical of the 'health of the mother' exception, since that has never been applied in good faith.
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J. Nobles
November 12, 2009 4:01 PM
The Stupak amendment also ghettoizes abortion procedures and medication in the same kind of market forces from which we're trying to extricate the health care system. That means there's no public option to help keep costs low, and therefore the costs of these procedures and medications will continue to skyrocket.
So the practical effect of the bill is more and more poor and middle-income women and families forced to pay for these procedures out-of-pocket, while all along the costs continue to rise exorbitantly.
That sounds like an undue burden to me.
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sj660
November 12, 2009 4:20 PM
I think there is definitely a viable challenge under Casey to this if it passes, but to tank the bill because of this is ludicrous.
People who don't have insurance now won't lose something they don't already have, but will gain tremendously in other aspects of their life.
Until I see something that tells me that this bill will leave people worse off financially (in which case it should be tanked), I can't agree that excluding a relative inexpensive medical procedure is reasons to deny everyone the benefits of it.
It's a craven, backstabbing amendment by Stupak. It's an insult to women, but I believe this was done at this time to get the eye off the public option and create a typical intra-Dem pie fight. And it's working.
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VictorLH
November 12, 2009 4:28 PM in reply to sj660
So you think we should treat half the population like second class citizens when they have a constitutional right to an abortion? So, lets crew the Equal Protection Clause of the Constitution so Insurance Companies can have their profits codified in the law.
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TaraV
November 12, 2009 4:56 PM in reply to VictorLH
Let's not confuse issues here. Having a right to something is not the same thing as saying who pays for it. I have 1) a constitutional right to birth control and 2) employer paid health insurance from a top US company and guess who pays for it?
I'm totally pro-choice but I can't see walking away from comprhensive HCR over a procedure that costs a few hundred bucks. I know...precedent and principle and all that but extneding basic health care coverage to millions of Americans who currently have none wins if the pro-choice side loses this round.
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artgurrl
November 12, 2009 4:28 PM
If the Stupak portion of this bill stays, couldn't it be challenged in a court of law as being discriminatory against women. As in holding out medical care that women need?
Please, no comments about plastic surgery or tummy tucks, we all know those are not medical conditions whereas pregnancy is a medical condition.
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Mateo123
November 12, 2009 4:29 PM
First: employer plans don't typically cover abortion.
Second: Sixty-four Democrats voted for Stupak. Sixty-four. If you're prepared to kill health care in exchange for choice, fine. But, the better solution is to pass health care and address the separate need that pro-choice folks feel is necessary at some later point in the session.
And, frankly, I don't think that the pro-lifers have the votes for the amendment in the Senate. So, if Reid is smart, his proposed bill would NOT include the Stupak bill. Then it would take 60 votes (if my understanding of senate rules is accurate) to add Stupak.
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Indie Pro
November 12, 2009 4:42 PM in reply to Mateo123
concerning your number one:
The best available evidence—from two studies conducted by the Guttmacher Institute and the Kaiser Family Foundation—suggests that most Americans with employer-based insurance currently have coverage for abortion. Further, as outlined above, direct billing does not equate to either extent of coverage or even use of coverage. Guttmacher’s 13% statistic, therefore, should not be cited as evidence that insurance coverage for abortion is not widespread or to suggest that restricting such coverage would have an impact on only a small minority of women.
http://www.guttmacher.org/media/inthenews/2009/11/11/index.html
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slb
November 12, 2009 6:03 PM in reply to Mateo123
But, the better solution is to pass health care and address the separate need that pro-choice folks feel is necessary at some later point in the session.
That won't happen. Not later in this session, probably not even within the next decade.
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artgurrl
November 12, 2009 4:34 PM
If this bill passes and mandates that people have to buy health insurance, couldn't it be challenged in a court of law as being a financial burden that cannot be met? Even though I believe we need health care reform, the more I see this bill as a huge give away to the insurance corporations and big Pharma. It's quite obvious that Medicare for all would be far more money saving and a better system than the one we have now and better than what this bill has to offer. Take the insurance corporations out because there is no need for a middle man in the health care system.
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PurpleAvenger
November 12, 2009 4:37 PM
well here's the other thing, that's an even greater burden - is that it would not only deny this coverage for women who have early (and normally less costly) abortions - the $200-600 someone else posted about - but it could hurt a lot of women who, often for medical reasons of the mother or fetus, have abortions later in the pregnancy, which are often in hospitals and MUCH more expensive. And even if the abortion is to save the mother's health, it would NOT be covered.
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DKDC
November 12, 2009 5:14 PM
Sigh.....
Please try and keep the facts straight - the bill extends Medicaid to ALL persons earning less than 150% of FPL, so this entire population will NOT be in the "Exchange."
Persons between 150-400 of FPL will, on a sliding scale, be eligible for subsidies. That does not mean they will automatically be participating in the Exchange - in fact, in the first few years, only the unemployed, self-employed and certain persons employed by firms under 100 employees will be eligible for the Exchange. At this point, you have already narrowed down the number of persons even affected by the Stupak Amendment drastically.
For those that are affected, all this speculation about whether or not they will have abortion coverage in their plans is just that - speculation. First of all, many of these women will be those who do not currently have any coverage at all - even if their plans don't cover abortion, are they better off without coverage?
And as someone pointed out, elective abortions are not the most expensive surgical procedures in the world, certainly not compared to pre-natal care, so the companies participating in the Exchange will have an incentive to offer plans covering abortions and/or supplemental riders to cover abortion for low cost.
Really concerned about ensuring that any women in this country can get an elective abortion whenever and whereever she wants? Support health reform and give money to your local abortion providing clinic, where most women receive this service as it is.
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VictorLH
November 12, 2009 7:48 PM in reply to DKDC
Oh, I see - lets just screw over a few women so the Health Insurance Industry can have profits codified in the law. At the same time, lets make everyone buy insurance and not let everyone have the option of a nationwide not for profit public option.
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kenga
November 13, 2009 10:48 AM in reply to VictorLH
I think that using the word "few" in this context is to misuse the word.
Look at poverty rates, look at the % of families below the poverty level that are headed by women, look at % of impoverished that are women, and consider that they will be subsidized.
Many of them can't afford enough FOOD on a weekly basis, and now we expect that they can come up with serious money for a procedure that isn't covered and without which they and there already-born children will be greatly burdened.
Serious money - and that's what $200 is when you're poor.
We're talking about MILLIONS of women.
That is definitely NOT a few.
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ryanwc
November 12, 2009 6:10 PM
How much does an abortion cost? I'm sure the question is complicated, but what range are we talking about, for a normal abortion, 1st trimester, no complications procedure?
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Pierce R. Butler
November 12, 2009 7:04 PM in reply to ryanwc
The typical no-complications 1st-tri abortion procedure runs between $400-500, maybe more in the higher-cost-of-living cities.
When I initially became involved in the issue, circa 1990, the going rate started at $300. There may have been less medical cost inflation in this field than in any other area of US health care.
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erwin
November 12, 2009 9:04 PM
I think the Stupak amendment is a poison pill designed to kill health care reform. It's not a matter of 'we're so close to HCR that it's OK to undermine woman's health care.' It was inserted to stop the progress of reform. It needs to be removed, that's all.
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Cal Damage
November 12, 2009 10:12 PM
This at least kills the entire 'tort reform' movement. The Christian right will create a tornado of civil suits at every level of government, at at every point of insurance or of actual service, implying that somehow federal Health Insurance funds were involved, either directly, indirectly in person (support frees up personal funds for separate policy) or indirectly at the insurance company level (rates are based on government-mandated clients steered by the federal law.)
Oh, it'll be grand. Almost all abortions, even private ones by the incredibly wealthy, will become functionally illegal, and have to be done out of sight, not of the law, but of the lawyers.
PS: Why does the Catholic Church continue to provide small boys to buggerers, but not protect women? Is it a misogyny thing, or what?
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IowaKid
November 13, 2009 9:23 AM
First what is wrong with the already Hyde Amendment that is already enforce. I do not understand why we have to have a separate amendment in the HRC bill for this just include the Hyde Amendment and be done with it. And by the way while you are at maybe we should start taxing churches if they have a voice in our legislation. Whatever happended to separation of state and church?
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Silence
November 15, 2009 8:56 AM in reply to IowaKid
Separation went out the window when govt started interfering with the church.
Note: See Washington DC homeless shelters and Catholic hospitals. The govt needs them them to carry a large part of the charity load, yet it threatens to eliminate tax exempt status and demands secular rules that oppose the teachings of the church.
It's quite a dilemma.
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JeffreyY
November 18, 2009 2:27 AM
Several people are saying things like "I for one will not accept leaving women behind when it comes to them having a constitutional right to [abortions]." I, on the other hand, will not accept leaving them and everyone else behind when it comes to the rest of health care. Those of us living privileged lives can, in fact, have it both ways. We just have to donate to the funds that help low-income women pay for abortions, happily listed at http://www.nnaf.org/. I should have been donating already, but I'm certainly going to start now.
It would be really stupid for progressives to block health care now, just because we personally don't want to pay extra to make sure women have access to abortion. Yes, we should try to repeal Stupak later, but get the big part—increased access to most health care—done now.
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