For abortion coverage, there's no choice

As Senate Democrats are apparently preparing to drop the public option, the next front line in the health care reform debate has emerged: abortion rights. It is a key issue in the Democrats' fight to win over Sen. Ben Nelson (D-NE), a moderate, anti-choice Democrat whose vote is necessary to reach the magic number of 60. Even now, Democrats are wooing him. According to TPM's Brian Beutler, Sen. Bob Casey (D-PA) gave Nelson “new legislative language to address how abortion services will be funded in Senate health care legislation,” which the Associated Press reported today that Nelson apparently rejected because it “doesn't get to the fundamental issue of barring federal funding for abortions.” That sounds like a prescription for more restrictive abortion language. And if past practice is any guide, it's certainly a prescription for terrible media coverage.

During the debate about the nearly identical anti-choice amendments -- the Stupak amendment in the House, which passed, and the Nelson amendment in the Senate, which didn't -- many in the media went along with the line fed to them by the amendments' supporters: it will not change the status quo established by the Hyde Amendment and, consequently, the bills as they are written will. The most egregious repeat offenders were multiple Fox News personalities, as well as MSNBC host Chris Matthews, who went along with the status quo line. In other words, move along ladies and gentleman, nothing to see here.

The only problem is that none of what they claimed was true. I think The New York Times explained the reality of the Stupak amendment (and consequently the virtually identical Nelson amendment) most clearly when writing in a November 9 editorial that the amendment “would prevent millions of Americans from buying insurance that covers abortions -- even if they use their own money.” The Times pointed out that amendment supporters “reached far beyond Hyde and made it largely impossible to use a policyholder's own dollars to pay for abortion coverage.” (The Hyde Amendment already bans direct federal payment for abortion services, with exceptions for pregnancies resulting from rape or incest, or when the mother's life is in danger.) The editorial continued:

If insurers want to attract subsidized customers, who will be the great majority on the exchange, they will have to offer them plans that don't cover abortions. It is theoretically possible that insurers could offer plans aimed only at nonsubsidized customers, but it is highly uncertain that they will find it worthwhile to do so.

In that case, some women who have coverage for abortion services through policies bought by small employers could actually lose that coverage if their employer decides to transfer its workers to the exchange. Ultimately, if larger employers are permitted to make use of the exchange, ever larger numbers of women might lose abortion coverage that they now have.

The restrictive language allows people to buy “riders” that would cover abortions. But nobody plans to have an unplanned pregnancy, so this concession is meaningless. It is not clear that insurers would even offer the riders since few people would buy them.

Similarly, a November 16 study by the George Washington University School of Public Health & Health Services assessing the impact of the Stupak amendment on “coverage of medically indicated abortions” concluded in part that:

In view of how the health benefit services industry operates and how insurance product design responds to broad regulatory intervention aimed at reshaping product content, we conclude that the treatment exclusions required under the Stupak/Pitts Amendment will have an industry-wide effect, eliminating coverage of medically indicated abortions over time for all women, not only those whose coverage is derived through a health insurance exchange. As a result, Stupak/Pitts can be expected to move the industry away from current norms of coverage for medically indicated abortions. In combination with the Hyde Amendment, Stupak/Pitts will impose a coverage exclusion for medically indicated abortions on such a widespread basis that the health benefit services industry can be expected to recalibrate product design downward across the board in order to accommodate the exclusion in selected markets.

But the problem with the media's coverage is not simply that they were wrong on the facts. Regurgitating talking points is lazy and often partisan, but when that talking point leads readers and viewers to believe that there is no debate -- that nothing is at stake -- it is sinister. Indeed, rolling back decades of women's rights gains under a Democratic-led health reform bill is something about which I'll venture to guess there is some debate, not to mention a significant media story.

So the media has a choice: If Casey's new legislative language -- or whatever is proposed to placate Nelson -- is anything like what Nelson was previously pushing, they can fulfill their journalistic obligation and report on the facts and implications of the amendment, or they could keep their viewers and readers in the dark.

It's an important choice, with serious implications for the choices women may -- or may not -- be able to make about their lives.