Health Reform Is No Place for an Abortion Fight
Lois Capps

We're Pro Choice Either Don't Get Pregnant or Don't be Poor those are the choices (c) Dan Wasserman
Pro Choice Either Don't Get Pregnant or Don't be Poor
(c) Dan Wasserman

The care of the nation is too important to let false arguments hold the floor

Lois Capps is a Democratic member of the House from California's 23rd Congressional District.

When Congress began debating health reform earlier this year, I hoped our focus would remain on the central goal of improving access to affordable, quality healthcare rather than on divisive issues like end-of-life care or abortion. I am a strong supporter of a woman's right to choose, and I make no apologies for my beliefs. However, I didn't believe that health reform legislation was the place to promote either a prochoice or anti-choice agenda. The focus needs to be on getting insurance to the nearly 50 million Americans without it and ensuring stability of coverage for the rest of us.

With this in mind, I tried to find a compromise for dealing with abortion services in health reform legislation that would be consistent with current law, neither expanding nor contracting access. The Energy and Commerce Committee adopted my amendment that would essentially continue the three-decades-old Hyde amendment's ban on federal funding for abortions, except in the case of rape or incest or to protect the life of the woman, while still allowing patients to access those services if paid for with private funds.

My amendment required insurers in the new health exchanges to keep federal funds strictly segregated from privately generated funds that might be used to pay for abortion services. This isn't simply an accounting gimmick, as some detractors have charged. Currently, some recipients of federal funds--like churches and military contractors--are required to segregate that money from other funding sources. For example, Roman Catholic hospitals receive billions of taxpayer dollars every year to help care for the sick. But the church must segregate these funds from its own money for religious activities. Surely, insurance companies can do the same.

My amendment also retained--and even expanded--current "conscience protections" so health professionals with moral objections to providing abortion services wouldn't be required to do so and couldn't be discriminated against for refusing to provide those services.

Furthermore, my amendment guaranteed that the exchanges would carry at least one plan that did not cover abortion as well as one that did so consumers would have more of a choice than they currently do (nearly 90 percent of plans cover abortion today). This provision was added at the request of pro-life members and groups concerned that individuals who soon would be required to carry health insurance should be able to buy a policy that doesn't cover abortion. Ironically, it is those very same groups that have attacked this provision.

My amendment was supported by both pro-life and pro-choice members of the Energy and Commerce Committee because it was consistent with existing law and formed through concessions from both sides of this issue. Trust me, nobody in the pro-choice community is happy about singling out a legal medical procedure for restrictions, but we understood the need to make concessions in order to achieve the larger goal of passing meaningful health reform. Fortunately, the bill now before the Senate contains a similar version of this carefully drafted compromise.

Unfortunately, the Stupak-Pitts amendment that replaced my amendment during House floor consideration goes well beyond the status quo and is in no way the simple extension of the Hyde amendment its proponents claim. It would result in a major step backward for women's control over their reproductive lives. First and foremost, it essentially stops insurance plans in the health exchanges from providing abortion coverage. It does this by banning anyone receiving any federal assistance, roughly 80 percent of people in the exchange, from purchasing a plan that provides abortion services. This restriction applies no matter how little federal assistance a consumer gets or how strictly the insurance company keeps federal funds separate from private funds.

And although Stupak amendment supporters claim that individuals not receiving federal assistance would have access to plans that cover abortion services, insurance companies would have to offer two nearly identical plans--one that does not cover abortion and one that does. But according to insurance industry consultants like Robert Laszewski, it wouldn't make any business sense to offer a plan that would be available to such a small number of potential customers. And that is why no one in the exchange--even those paying for insurance completely on their own--would have access to abortion coverage. The argument that this amendment won't restrict access for women who are paying for insurance entirely out of their own pockets is false.

Stupak amendment proponents also argue that women could purchase an insurance "rider" covering abortion. But based on precedence, that is highly unlikely. In Oklahoma and North Dakota, for example, where insurance coverage of abortions is restricted by state law, no companies offer "riders" because there is no market for a product based solely on one procedure. A recent report by George Washington University similarly concluded that the effect of the Stupak amendment would "militate against the creation of a supplemental coverage market."

Stupak amendment proponents have made other claims that don't hold water, such as the mythical monthly "abortion fee" levied on everyone in the exchange, but independent observers like Politifact.com correctly labeled this "False." We need to strike a balance on this issue so health reform isn't a casualty of divisive abortion politics. That's what my amendment did, and that's what the Senate bill proposes. Congress would be wise to send the president a bill reflecting this common-ground approach, and I will work hard to see that happens.

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Chaos and Organization in Health Care