Not My Tax Dollars!

Rep. Lois Capps Refutes Stupak's Continuing Claims.

From RHRealityCheck:

On Wednesday, December 9th, the New York Timespublished an op-ed by Congressman Bart Stupak in which he makes misleading claims about the Stupak-Pitts Amendment in the House Health Care Reform bill. Here, Congresswoman Lois Capps (D-CA), author of the Capps Amendment, provides a reality check to the claims in that op-ed.

Bart Stupak's claim: Our amendment maintains current law, which says that there should be no federal financing for abortion.

Reality: The Stupak-Pitts amendment goes well beyond the status quo and is in no way the simple extension of the Hyde amendment its proponents claim. It dramatically restricts consumers’ ability to purchase comprehensive health plans that include coverage for abortion services in the health exchange. In contrast the Capps Amendment would havecontinued the prohibition of federal funding of abortion services, but did so without restricting insurance coverage of this legal medical procedure when it is paid for with private funds. Reputable third parties, like a recent study from George Washington University, have found that the Stupak amendment would restrict coverage of abortion services even when paid for entirely with private funds.

Stupak's claim: Under our amendment, women who receive federal subsidies will be prohibited from using them to pay for insurance policies that cover abortion. The amendment does not prevent private plans from offering abortion services and it does not prohibit women from purchasing abortion coverage with their own money. The amendment specifically states that even those who receive federal subsidies can purchase a supplemental policy with private money to cover abortions.

Reality: There is nothing in the Stupak-Pitts Amendment to ensure that riders are available or affordable to individuals purchasing coverage in the Exchange. There is no evidence that insurance companies actually offer such riders in the five states that currently require women to purchase a separate rider for abortion coverage. It is not practical to expect women to plan ahead for an unintended pregnancy, or a pregnancy that goes terribly wrong, by purchasing a supplemental rider. Furthermore, if only women of childbearing age purchase such a rider then the premium for the rider will likely cost almost as much as the service.

Stupak's claim: Some opponents of the amendment have tried to argue that it would effectively end health insurance coverage of abortion in both the private and public sectors. This argument is nothing more than a scare tactic.

Reality: It is highly unlikely that any insurance plan is going to go through the pain staking process of setting up two separate plans —one with abortion services offered and one without – to cater to less than 20% of the Exchange participants who are allowed to buy plans that include abortion services. As noted by Robert Laszewski, consultant to the insurance industry, in a recent interview with NPR, it wouldn’t make any business sense to offer a plan that would only be available to such a small number of potential customers. The recent report by George Washington University referenced above similarly concluded that the effect of the Stupak amendment would “militate against the creation of a supplemental coverage market.” 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's claim: The language in our amendment is completely consistent with the Hyde Amendment, which in the 33 years since its passage has done nothing to inhibit private health insurers from offering abortion coverage. There is no reason to believe that a continuation of this policy would suddenly create undue hardship for the insurance industry — or for those who wish to use their private insurance to pay for an abortion.

Reality: The Stupak-Pitts amendment goes well beyond the status quo and is in no way the simple extension of the Hyde amendment. The Hyde amendment prohibits federal funding for abortion in Medicaid programs except in cases of rape, incest and to protect the life of the women, but it allows states to use their own funds to pay for abortions in other cases. Applying this same principle, the Capps Amendment, would have prohibitedfederal funding to pay directly for abortions in insurance plans in the Exchange, but would allow plans to pay for these services using private funding from patient premiums. Just as churches and military contractors are able to segregate federal funds from other sources of funding, insurance companies can do the same.

Stupak's claim: Given that insurance companies are able to offer separate plans with and without abortion coverage now, it seems likely that they would be able to continue to do so on the newly established health insurance exchange.

Reality: The Stupak-Pitts Amendment severely limits private plans’ ability to cover abortions. The Stupak-Pitts Amendment would prohibit any abortions beyond the Hyde exceptions within the public option and any plans sold in the Exchange to individuals who receive affordability credits. Although insurance companies are permitted to offer plans that cover abortion to individuals who do not receive affordability credits, they would only be able to do so if they offered two nearly identical plans with the only difference being coverage and exclusion of abortion services. Furthermore health insurance companies would be unlikely to even offer a plan that does receive any funding from affordability credits because the risk pool would be too small. In effect, this ensures there will not be any private plans covering abortion available to individuals and small businesses that purchase health insurance in the new Exchange.

Stupak's claim: It is also disingenuous to argue (as some have) that it would be a hardship for insurance companies to provide plans with and without abortion coverage — when the health care bill as introduced in the House and Senate mandated exactly that. Under language suggested by Representative Lois Capps, Democrat of California, the new insurance exchange would be required to provide at least one plan that covers abortion and one plan that does not. If offering separate abortion-free plans in this way was acceptable under the Capps language (which has been endorsed by abortion-rights groups), then it should also be acceptable under the Stupak-Ellsworth-Pitts amendment.

Reality: Under the Capps language the Exchange would have to ensure that there is at least one plan that does not include abortion services and one that does. These plans could be offered by the same company or different companies, so long as consumers were offered at least one of each option. In contrast the Stupak amendment requires private plans that want to offer a comprehensive plan including abortion services – and most private plans currently do offer comprehensive plans – they would have to offer an identical plan that does not include abortion services. So if Blue Cross Blue Shield wanted to offer a comprehensive plan they would also have to offer an identical plan without those services. According to insurance industry consultants like Robert Laszewski it wouldn’t make any business sense to offer a plan that would only be available to such a small number of potential customers (since less than 20 percent of the exchange customers would even be allowed to purchase a comprehensive plan). And that is why anyone in the Exchange – even those paying for insurance completely on their own – wouldn’t 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's claim: While many accusations have been thrown around in recent months, the intent behind our amendment is simple and clear: to continue current law, which says that there should be no federal financing of abortions. Our intent was not to change, add or take anything away from federal law.

Reality: The Stupak-Pitts amendment goes well beyond the status quo and is in no way the simple extension of the Hyde amendment its proponents claim. It dramatically restricts consumers’ ability to purchase comprehensive health plans that include coverage for abortion services in the health exchange. In contrast the Capps Amendment continued the prohibition of federal funding of abortion services, but did so without restricting insurance coverage of this legal medical procedure when it is paid for with private funds. Reputable third parties, like a recent study from George Washington University, have found that the Stupak amendment would restrict coverage of abortion services even when paid for entirely with private funds.

Stupak's claim: This goal is consistent with the opinion of a majority of Americans. Recent CNN and Washington Post-ABC News polls found that 61 percent of Americans do not want taxpayer dollars to pay for abortions. And while the Senate voted down a similar amendment on Tuesday, I’m hopeful that the spirit of our legislation will make it into the final bill.

Reality: The Capps language is consistent with both current law and public opinion because it explicitly prohibits federal funding for abortion services except those allowed by the Hyde amendment: rape, incest, and to protect the life of the woman. Furthermore, recent polling conducted by the Mellman Group found that:

• 54% of voters would oppose a health care reform plan that prevented private insurance plans from covering abortion.

• 56% of voters believe that those who receive partial subsidies should be able to buy plans that cover abortion – surpassing those who oppose this choice by a 20 point margin.

• 52% of voters support the “Capps compromise,” which would prohibit federal dollars, including partial subsidies, from being used to pay for abortions, though abortions could be paid using private funds generated by patients’ premiums.

• 47% agreed that “Political differences should not prevent us from moving forward on an otherwise good healthcare reform plan.”

As pollster Mark Mellman noted a column in the Hill recently (http://thehill.com/opinion/columnists/mark-mellman/68251-abortion-and-health-reform-debate), “Americans do not want reform to be an excuse for tightening restrictions on abortion or for taking away health coverage millions already have. Nor do they want an abortion debate to stop reform. Voters want an abortion-neutral healthcare reform.”

Calling Out "Abortion Neutral" Rhetoric.

Catholic bishops are not uneducated, uninformed men.

Today Frederick Clarkson has an article warning us about how Hyde has become "abortion neutral." You must read the article.

And a quote from Cardinal DiNardo blatantly uses that standard to criticize the Senate for defeating Nelson, though he hypocritically gets funding wrong. If the Catholic Church can receive funds from the federal government for social services that may not be used for religious purposes and keep the money straight, how come the health care bill and the federal government isn't given the same expectation?

Clearly, it's because they are getting what they want. They are pushing back public perception of abortion. They have instilled in us that Hyde is acceptable. They will continue their push to apply Catholic doctrine to women's health care access. This isn't about protection of public money from abortion usage. This is about slowly and gradually working toward their objective: the eradication of abortion. The Catholic church is a very patient body.

Cardinal Daniel DiNardo, the new chairman of the bishops’ Committee on Pro-Life Activities, also spoke up about the Nelson amendment loss.

“Congress needs to separate facts and truth from political rhetoric on abortion funding. Even our opponents claim they do not support federal funding for elective abortions and they want current restrictions to apply," he said.

"The way to settle this often misleading debate is simply, clearly and explicitly to apply Hyde restrictions to all the federal funds in the legislation. That is what the House did and what the final bill must do. The Senate should not approve this bill in its current form," he added.

WSJ Letters on Abortion Funding.

Two letters appear on the Wall Street Journal web site today. The first is by Guttmacher, the second by an individual in Michigan:

Sometimes accurate statistics can be used to draw inappropriate conclusions ("Limited Effect Seen in Abortion Clause," U.S. News, Nov. 17). True, the Guttmacher Institute estimates that some 160,000 women's abortions are currently direct-billed by the provider to private insurance plans annually, with an unknown, additional number of women seeking reimbursement after the fact. Also true, first-trimester abortions, which constitute 90% of all procedures, typically cost just over $400.

However, even putting aside the fact that later abortions, for instance in cases of fetal anomalies, can cost many thousands of dollars, neither of these figures is small, certainly not so small as to justify eliminating abortion coverage in private insurance plans. No one makes that case for other procedures that occur at similar rates or cost similar amounts, though for most people having to pay entirely out-of-pocket might not constitute an "insurmountable burden."

This is what is relevant: Abortion is a legal medical procedure that is recognized by health-care professionals to be medically appropriate and in some cases medically necessary, and its coverage by private insurance is currently the norm. American women, one in three of whom at current rates will have an abortion by age 45, shouldn't be denied the ability to purchase insurance that covers abortion care regardless of how many women use this coverage today.

A central reason why some women who have insurance that covers abortion choose not to use it is that the stigma surrounding abortion makes them fearful about who will find out. That antiabortion activists who have worked for decades to perpetuate that stigma are now using it to argue that the option of insurance coverage is underused and therefore unnecessary is deeply cynical.

Cory L. Richards

Executive Vice President

Guttmacher Institute

Washington

The 29-year-old Colorado woman's statements that abortion is "a woman's choice" and that the restriction on abortion in the House abortion bill "infringes on that choice" are ludicrous. Just because abortion is a woman's choice doesn't mean that the woman has the right to force a total stranger (i.e., a taxpayer) to pick up the tab for that choice. You cannot call something a "right" or a "choice" when exercising that "right" or "choice" means forcing someone to pay for it against his or her will. What about the right of taxpayers to spend their money as they see fit?

Chris Douglas

Grand Blanc, Mich.

Chris Douglas does some selective thinking here, not an uncommon approach to abortion funding. Where does he think the rest of his tax dollars go? Are all federal funds used for services that he approves of? And what makes him think that he has a right to dictate where tax dollars go when 1 in 3 women in the US is discriminated against by the Hyde Amendment? This "my federal dollars" rubbish is ludicrous, and used to protect a vocal minority's imposition of ideology on a legal service for all women.