Abortion and Health Reform: What the Bills Actually Say

I've been reading – from the Washington Post to Time to really awesome blogs – that abortion is going to derail health reform.

I’d like to call a time-out and explain what is actually included in the legislation, both House and Senate versions. The amount of hysteria over health reform generally, and women’s reproductive health in particular, is alarming. What we need are some facts. And, of course, we need for women’s reproductive health not to be the sacrificial lamb. Again.

So, onto some facts...

House version: The House version does not contain the word abortion.

The House version had to be approved by three committees: Education and Labor, Ways and Means, and Energy and Commerce. During debate on the bill before Ways and Means, Rep. Sam Johnson (R-TX) tried to amend the bill to prohibit coverage for abortion services except in cases of life endangerment, rape, or incest. His amendment failed, 19-22.

When Energy and Commerce took up the bill, an amendment by Rep. Joseph Pitts (R-PA), would have prohibited abortion coverage except in cases of life endangerment, or forcible rape or incest. Forcible rape or incest? Are there other kinds? And what is forcible anyway? Do bruises count or would you need broken bones? Anyway, his ridiculously offensive amendment failed, 29-30. Rep. Bart Stupak (D-MI) offered a similar amendment – sans "forcible" – that also failed, 27-31.

Two abortion-related amendments were approved. The first, by Rep. Stupak, ensures that medical providers, health plans, or institutional entities may NOT be discriminated against because they refuse to “provide, pay for, provide coverage of, or refer for abortions.” The amendment protects people who don’t want to participate in abortion services. It passed by simple voice vote.

The second, by Rep. Lois Capps (D-CA) prohibits abortion as a covered service under the minimum benefits package. Like the Stupak amendment, this one also would prohibit any health plan in the exchange from discriminating against medical providers, health plans, or institutional entities because of their willingness or unwillingness to provide, pay for, provide coverage of, or refer for, abortion. Finally, it would clarify that nothing in the underlying bill could be construed to preempt any state laws on abortion, including parental consent, and that the bill would not affect federal conscious clause requirements. It passed, 30-28.

(The minimum benefits package is the floor – the lowest number and type of procedures that health insurance plans in the health care exchange would be required to provide coverage of. It includes mental health services, substance abuse services, physical benefits, anything that received an “A” or “B” rating in the current recommendations of the United States Preventive Services Task Force; maternity care; and well baby care.)

Senate Version: Like the House version, the Senate version does not contain the word abortion.

The Senate version needs to be approved by two committees, Health, Education, Labor and Pensions (HELP, jurisdiction over public health, employment) and Finance (jurisdiction over revenue/tax/Social Security/Medicaid/Medicare/SCHIP). So far, only HELP has approved its version; Finance expects to release a version on September 15.

Anyway, HELP started debating the bill back in June and finished up in mid-July. On July 13, the committee defeated a couple of amendments – one by Sen. Mike Enzi (R-WY) to prohibit anything in the bill as being construed to require coverage; one by Sen. Orrin Hatch (R-UT) to codify the Hyde Amendment; one by Sen. Tom Coburn (R-OK) to prohibit the Secretary of HHS from overturning any state law on abortion. All failed, 11-12.

Why this all matters anyway: This post is a rather desperate and elaborate plea to pay attention to the policy, not just the politics. With everyone shouting from the rooftops about the bill being either the 2d coming or a pinko-commie plan to kill puppies and ban rainbows forever, it is far too easy to tune out. Or to get caught up in someone else's talking points.

No one expects that most people are going to read the 1000+ pages of the House bill or the 600+ pages of the Senate bill. But there are many, many resources that will clearly report on the provisions and on amendments.

Don’t get overwhelmed. Try not to get lost in the rhetoric. Try Kaiser Daily Health News. A short, daily email covering major developments and headlines.

Try Ezra Klein’s blog at the Washington Post; he brings in economists, researchers, and links to fiscal analysis so as to really explain the short- and long-term financial implications of passing (and not passing) health reform. Try The Source, where a weekly newsletter (published every week either the House or Senate is in session) breaks down the action.

(For more on the economic benefits of family planning, I direct you to to my very first post for MOMocrats.)

Comments

[Lawyer Mama]

Thanks, Melissa, for a clear explanation of what's out there.

[a w]

i think the term "forcible" is used to make a distinction between non-consensual sex (aka forcible rape) and statuatory rape which is not "forcible".

[babyhawk mei tai]

Abortions are murder of human life and we have no right to continue with them.