From Gerson's December 23 Washington Post column:

Instead, Nelson caved. The “compromise” he accepted allows states to prohibit the coverage of elective abortions in their insurance exchanges. Which means that Nebraska taxpayers may not be forced to subsidize insurance plans that cover abortions in Nebraska. But they will certainly be required to subsidize such plans in California, New York and many other states.

In the end, Nelson not only surrendered his beliefs, he also betrayed the principle of the Hyde Amendment, which since 1976 has prevented the coverage of elective abortion in federally funded insurance. Nelson not only violated his pro-life convictions, he also may force millions of Americans to violate theirs as well.

I can respect those who are pro-life out of conviction and those who are pro-choice out of conviction. It is more difficult to respect politicians willing to use their deepest beliefs -- and the deepest beliefs of others -- as bargaining chips.

In a single evening, Nelson managed to undermine the logic of Medicaid, abandon three decades of protections under the Hyde Amendment and increase the public stock of cynicism.

FACT: Senate bill prohibits health insurers from using federal subsidies “for the purposes of paying for” abortion services restricted by Hyde.

The Senate health care reform bill states that if a “qualified health plan” offered under the health insurance exchange provides coverage of abortion services for which public funding is banned, “the issuer of the plan shall not use any amount attributable” to the subsidies created under the bill “for purposes of paying for such services.” From Section 1303(b)(2)A):

''(2) PROHIBITION ON THE USE OF FEDERAL FUNDS.-

''(A) IN GENERAL.-If a qualified health plan provides coverage of services described in paragraph (1)(B)(i), the issuer of the plan shall not use any amount attributable to any of the following for purposes of paying for such services:

''(i) The credit under section 36B of the Internal Revenue Code of 1986 (and the amount (if any) of the advance payment of the credit under section 1412 of the Patient Protection and Affordable Care Act).

''(ii) Any cost-sharing reduction under section 1402 of the Patient Protection and Affordable Care Act (and the amount (if any) of the advance payment of the reduction under section 1412 of the Patient Protection and Affordable Care Act).

FACT: Manager's amendment to Senate bill establishes a separate premium to segregate funds used to pay for abortions from federal funds

A provision in Senate Majority Leader Harry Reid's managers amendment to the bill requires issuers to “collect from each enrollee” in plans that cover abortions “separate payment” for “an amount equal to the actuarial value of the coverage of” abortion services. This value must be at least $1 per enrollee, per month. All such funds are deposited into a separate account used by the issuer to pay for abortion services; federal funds and the remaining premium payments are used to pay for all other services.

FACT: Current law allows coverage for abortions restricted by Hyde under Medicaid through similar fund segregation

Seventeen states use state funds to cover abortions for Medicaid recipients in circumstances beyond Hyde. According to a November 1 study by the Guttmacher Institute, 17 states provide coverage under Medicaid for “all or most medically necessary abortions,” not just abortions in cases of life endangerment, rape, and incest. Those states “us[e] their own funds” -- not federal funds -- “to pay” for the procedures. Therefore, in 17 states, Medicaid, a b000-.html" title="http://www.law.cornell.edu/uscode/42/usc_sec_42_00001396b000-.html">federally subsidized health care program, covers abortions in circumstances in which federal money is prohibited from being spent on abortion.