GOP proposal would have prohibited insurance plans that cover abortion from participating in exchange

Stupak-Pitts proposal prohibited federal funds from being used “to cover any part of the costs of any health plan that includes coverage of abortion.” From the Stupak-Pitts amendment, which was rejected by the House Energy and Commerce Committee by a 31-27 vote:

No funds authorized under this Act (or an amendment made by this Act) may be used to pay for any abortion or to cover any part of the costs of any health plan that includes coverage of abortion, except in the case where a woman suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the woman in danger of death unless an abortion is performed, including a life-endangering physical condition caused by or arising from the pregnancy itself, or unless the pregnancy is the result of an act of rape or incest.

Plans that participate in exchange must accept customers that receive government subsidies, so Stupak-Pitts amendment would have prohibited plans that cover abortion from participating in exchange. As stated by a House staff description of the House bill, Section 112 "[r]equires guaranteed issue (no one can be denied health insurance)," and Section 112 applies to insurance “offered to individuals ... through the Health Insurance Exchange.”

Many plans offered by employers currently cover abortion. According to the Guttmacher Institute, the “best available evidence” on the extent of coverage of abortion by employer-sponsored health insurance plans comes from a Guttmacher Institute study finding that “87% of typical employer-based insurance policies in 2002 covered medically necessary or appropriate abortions” and a 2003 Kaiser Family Foundation study finding that 46% of covered workers had abortion coverage. Guttmacher stated that the large difference in results stemmed from different methodologies: Guttmacher surveyed “medical directors of insurance companies and asked them about the typical insurance policy they wrote for employers” while the Kaiser Family Foundation surveyed “employers' human resources staff and asked about their firm's coverage.”

Many Americans currently covered by employer-sponsored plans would switch to exchange-provided insurance under plan and would therefore lose option of coverage for abortion. The Congressional Budget Office estimates that in 2016, “about 9 million people who would otherwise have had employer coverage would not be enrolled in an employment-based plan under the proposal.” Such employees would have to enroll in health insurance through the exchanges unless they qualified for another insurance program such as Medicare or Medicaid. All told, the CBO estimates that 30 million people will participate in the exchanges, all of whom would, under the Stupak-Pitts proposal, therefore be barred from purchasing insurance that covers abortion regardless of whether they received subsidies.

Media “fact checks” fail to note GOP proposal to ban abortion coverage through exchange

CBS' Attkisson “searched for answers” on abortion question but didn't note the GOP amendment:

SHARYL ATTKISSON (CBS News investigative correspondent): But separating fact from fiction isn't always easy in a health care reform bill that's not finished. In fact, four different versions have been approved by congressional committees. We searched for answers among the three drafts available. On abortion --

UNIDENTIFIED WOMAN: What is your position on taxpayer-funded abortion, which will increase the death of preborn infants by 30 percent?

ATTKISSON: Would the government pay for abortion? That's unclear. Two of the bills don't address the question at all. Under one version, abortions would have to be available through at least one insurance plan. But Democrats say abortions would be paid for with the patient's premium, not federal money. [CBS Evening News, 8/12/09]

ABC fact check fails to note facts about the conservative proposal:

[begin video clip]

KATE SNOW (correspondent): Will health care reform lead to taxpayer-funded abortions? Unclear. Current law states federal funds cannot be used for abortions except in the cases of rape, incest or the life of the mother. But under health care reform, lower income Americans would have their health care subsidized by the government, and they will be allowed to pick a health plan that covers abortion. The president has said the government should not pay for it.

PRESIDENT OBAMA: You know I'm pro-choice. But I think we also have a tradition of, in this town, historically, of not financing abortions as part of, you know, government-funded health care.

SNOW: One version of the House reform bill would allow health plans to cover abortions as long as they were paid for entirely with private funds. It might not be the easiest thing to regulate, keeping public and private money separate, but experts say it could work.

[end video clip]

SNOW: That version of the House bill may end up being the final version, but frankly, we just don't know yet. And, of course, the Senate is working on its own version. So, the bottom line is, we don't know yet if taxpayers could end up funding abortions. It is up to the members of Congress, Charlie, and the president. [World News, 8/13/09]

Cleveland Plain Dealer fact check reports that Stupak is “dissatisfied” with abortion language but not effect of his proposal:

Some anti-abortion members of Congress are dissatisfied with the language in the bill. For example, Michigan Democrat Bart Stupak doesn't think there would be a realistic way to separate the federal money from private money to ensure that no tax dollars go to abortion.

The National Right to Life Committee labels [California Democrat Lois] Capps' amendment “a phony compromise” that would allow subsidies to private insurance plans that cover elective abortion.

Toledo Democrat Marcy Kaptur, who also opposes abortion, doesn't think the bill will lead to taxpayer-funded abortions because of the Hyde Amendment, language attached each year to a funding bill for the Department of Health and Human Services which blocks government funding of abortions.

But the legislative language Capps proposed would allow use of federal money to pay for abortions if Congress ever stops its yearly renewal of the Hyde Amendment.

It's hard to know what will end up in the final plan Congress considers because the bills before the House of Representatives and Senate are still in flux. [The Plain Dealer, 8/17/09]

Los Angeles Times fact check also ignores effect of conservatives' proposal:

Would the government start paying for abortions?

That's unclear. Neither House nor Senate versions of the healthcare legislation contains any requirement that federal funding be made available for abortions. Claims that tax dollars will be used for abortions, as a television ad from the Family Research Council contends, are premature and somewhat misleading.

But the legislation is short on many details. Depending on how regulations are written, some women who got federally subsidized insurance might be able to buy plans that cover abortions.

Under the most popular Democratic proposals, millions of Americans would buy their insurance in a new, highly regulated marketplace in which private insurers and the government would offer a choice of health plans. Many of those people would qualify for federal aid to defray the cost of at least part of their premiums.

It appears unlikely that the government would require the plans in this marketplace to cover abortions. In fact, one version of the legislation explicitly prohibits such a requirement. But some private insurers in the exchange might cover abortion services. If a woman who received public subsidies for her coverage selected one of those plans, it could be argued that the government was helping to fund abortions. [Los Angeles Times, 8/10/09]

Alternative proposal forbids government funding for abortion but not ability of plans to offer abortion coverage

House committee has voted in favor of Capps amendment that forbids government funding. The House Energy and Commerce Committee agreed by a 30-28 vote to an amendment sponsored by Capps that prohibits “the expenditure of Federal funds” for abortions for which the Department of Health and Human Services (HHS) cannot spend funds on. Currently, HHS is prohibited from spending funds on any abortions except in cases of danger to a pregnant woman's life or in cases of rape and incest under the Hyde Amendment.

Unlike Stupak-Pitts amendment, Capps amendment would allow people to purchase plan that covers abortion through exchange. The Capps amendment directs the agency overseeing the exchange to ensure that in every area of the country, there exists at least one exchange-participating plan that provides coverage for abortion and one plan that does not provide such coverage. It also requires plans that do cover abortion to ensure that “any affordability credits provided under subtitle C of title II are not used for purposes of paying for” abortions other than in cases of rape and incest and in cases where the pregnant woman's life is in danger.

Transcripts

From the August 12 broadcast of the CBS Evening News with Katie Couric:

ATTKISSON: But separating fact from fiction isn't always easy in a health care reform bill that's not finished. In fact, four different versions have been approved by congressional committees. We searched for answers among the three drafts available. On abortion --

UNIDENTIFIED WOMAN: What is your position on taxpayer-funded abortion, which will increase the death of preborn infants by 30 percent?

ATTKISSON: Would the government pay for abortion? That's unclear. Two of the bills don't address the question at all. Under one version, abortions would have to be available through at least one insurance plan. But Democrats say abortions would be paid for with the patient's premium, not federal money.

From the August 13 broadcast of ABC's World News with Charles Gibson:

GIBSON: And at the town hall meetings, the subject of abortion is often mentioned. Many questioners maintaining that reform would put the government in the business of paying for abortions. Well, are they right? As we continue fact checking the health-care battle, Kate Snow looks at the questions surrounding abortion.

[begin video clip]

SNOW: Senator Arlen Specter was asked about abortion at a town hall meeting this week.

SEN. ARLEN SPECTER (D-PA): Young lady, you have the floor.

UNIDENTIFIED WOMAN: I do not want to pay on a health care plan that includes the right for a woman to kill her unborn baby. Is it true that this plan is in the health care bill?

SNOW: The basic question there: Is the right to abortion included in health care reform? The facts: The original bills in both the House and Senate never explicitly addressed the subject, but that doesn't mean it doesn't come up.

UNIDENTIFIED MAN: I'm referring to Section 1714 that talks about family planning services. All right? Starts on Page 769.

SNOW: He's not wrong. Section 1714 does talk about family planning for women on Medicaid. It will allow states to counsel or provide abortion, using state money. But could federal money be used toward abortion? That is the question that comes up most often at those town hall meetings.

UNIDENTIFIED WOMAN: I'm talking about taxpayer-funded abortion. We have to pay for it, OK, whether we agree with it or not.

SNOW: Will health care reform lead to taxpayer-funded abortions? Unclear. Current law states federal funds cannot be used for abortions except in the cases of rape, incest, or the life of the mother. But under health care reform, lower income Americans would have their health care subsidized by the government, and they will be allowed to pick a health plan that covers abortion. The president has said the government should not pay for it.

OBAMA: You know I'm pro-choice. But I think we also have a tradition of, in this town, historically, of not financing abortions as part of, you know, government-funded health care.

SNOW: One version of the House reform bill would allow health plans to cover abortions as long as they were paid for entirely with private funds. It might not be the easiest thing to regulate, keeping public and private money separate, but experts say it could work.

[end video clip]

SNOW: That version of the House bill may end up being the final version, but frankly, we just don't know yet. And, of course, the Senate is working on its own version. So, the bottom line is, we don't know yet if taxpayers could end up funding abortions. It is up to the members of Congress, Charlie, and the president.

GIBSON: All right, Kate Snow reporting, fact-checking again tonight.